Peggy Mentor, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

262150 Issued in MA

Practice address

940 Belmont St
Brockton, MA 02301-5596

Phone

(857) 364-4418

Fax

(774) 826-3157

NPI assigned

Oct 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Peggy Mentor Former name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• First-Class Behavioral & Counseling Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, MA
  • NPI 1336870864
  Medicare reassignment NPD
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Brookline, MA
  • NPI 1720486830
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1609387695
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Heather Shaffer MD PA

  • Family Medicine Physician
  • Panama City, FL
  • NPI 1790877512
  NPD (past)
• Primecare of NW FL

  • Family Medicine Physician
  • Panama City, FL
  • NPI 1801940549
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1023006525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "857-364-4418",
            "fax_number": "774-826-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "857-364-4418",
            "fax_number": "774-826-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTOR",
        "first_name": "PEGGY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "C53573",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "262150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023006525",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "MENTOR",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ciara Mendes, BA
• Joshua Galvao Mendes
• Kassandra Brown Mendez, LPN
• Ashley Paulino Mendonca
• Alejandro Y Mendoza, M.D.
• Mabel Mercedes Estrella
• Vikas Merchia, M.D.
• Cynthia Mercier
• Mercury Operator, LLC
• Mercy Human Services & Home Health Care

• Geriatric Medicine (Family Medicine) Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Geriatric Medicine (Family Medicine) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.