Individual provider Active NPI

Emily Lindsay Mendolla

  • Family Nurse Practitioner
  • Arvada, CO
National Provider Identifier
1013632579
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0998111-NP Issued in CO
Practice address
12650 W 64TH Ave # E501
Arvada, CO 80004-3893
Phone
(000) 000-0000
NPI assigned
Oct 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32753 TN
Family Nurse Practitioner 363LF0000X APN.0998111-NP CO Primary

Addresses

Primary practice location

12650 W 64TH Ave # E501
Arvada, CO 80004-3893

Mailing address

12650 W 64TH Ave # E501
Arvada, CO 80004-3893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007002241 CO Practitioner - Nurse Practitioner 1658748017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Term Care and Rehab ConsultantsGroup PAC ID 5294733861, 58 clinicians

Practice addresses (Care Compare)

4800 Tabor St
Wheat Ridge, CO 80033-2112
Phone (303) 421-4161

Merit-based Incentive Payment System (MIPS)

Final score
82.97 of 100Reported as group
Quality
73.18
Improvement activities
40
Cost
65.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Long Term Care and Rehab Consultants CurrentSince Oct 14, 2024 Accepting new patients

Locations

12650 W 64th Ave
Unit E501
Arvada, CO 80004
Phone (303) 431-4127

7481 Knox Pl
Westminster, CO 80030
Phone (303) 238-7505

4800 Tabor St
Wheat Ridge, CO 80033
Phone (303) 421-4161

Interoperability endpoints

  • Direct secure messaging: emily.ewing@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1013632579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 W 64TH AVE # E501",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800043893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 W 64TH AVE # E501",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800043893",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOLLA",
        "first_name": "EMILY",
        "middle_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32753",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998111-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.