Mr Matthew Lawrence Mongillo, BA, AA, MHRS, RE is a
Rehabilitation Practitioner based in San Jose, California. Mr Matthew Lawrence Mongillo is licensed to practice in * (Not Available) (license number ) and his current practice location is
232 E Gish Rd, San Jose, California. He can be reached at his office (for appointments etc.) via phone at
(669) 221-0148.
NPI number for Mr Matthew Lawrence Mongillo is 1609949734 and his current mailing address is 232 E Gish Rd, San Jose, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1609949734.
Healthcare Provider's Profile
| Full Name | Mr Matthew Lawrence Mongillo |
|---|
| Gender | Male |
|---|
| Speciality | Rehabilitation Practitioner |
|---|
| Location | 232 E Gish Rd, San Jose, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1609949734
- Provider Enumeration Date: 11/16/2006
- Last Update Date: 07/09/2025
Medical Identifiers
Medical identifiers for Mr Matthew Lawrence Mongillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609949734 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 225400000X | Rehabilitation Practitioner | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Matthew Lawrence Mongillo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Matthew Lawrence Mongillo, BA, AA, MHRS, RE
232 E Gish Rd,
San Jose, CA 95112-4706
Ph: (669) 221-0148 | Mr Matthew Lawrence Mongillo, BA, AA, MHRS, RE
232 E Gish Rd,
San Jose, CA 95112-4706
Ph: (669) 221-0148 |
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