NPIMap

Individual provider Active NPI

Carmelo Cabalu Mendiola, MD

  • Internal Medicine Physician
  • Fort Payne, AL
National Provider Identifier
1023063922
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00017265 Issued in AL
Practice address
2202 Jordan Road SW
Suite 500
Fort Payne, AL 35968-3688
Phone
(256) 844-2825
Fax
(256) 844-2834
NPI assigned
May 23, 2006
Last updated
Jan 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00017265 AL Primary

Addresses

Primary practice location

2202 Jordan Road SW
Suite 500
Fort Payne, AL 35968-3688

Mailing address

2202 Jordan Road SW
Suite 500
Fort Payne, AL 35968-3688
Phone (256) 844-2825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060817000608 AL Practitioner - Internal Medicine 2961405618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2202 Jordan Rd SW
Suite 500
Fort Payne, AL 35968-3692
Phone (256) 844-2825

2202 Jordan SWRD
Suite 500
Fort Payne, AL 35968-3692

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00017265ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendiola PC Internal Medicine CurrentSince Jan 1, 2002 Accepting new patients
Fort Payne Hospital Organization Past Accepting new patients

Locations

2202 Jordan Rd SW
Ste 500
Fort Payne, AL 35968
Phone (205) 997-2820

Networks

  • MS PPO
  • MS PPO C-SNP
  • MS PPO D-SNP
  • FL PPO

Interoperability endpoints

  • Direct secure messaging: cmendiol@yourcarecommunity.org

Organizations & group practices 2

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

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1023063922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 JORDAN ROAD SW",
            "address_2": "SUITE 500",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683688",
            "telephone_number": "256-844-2825",
            "fax_number": "256-844-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 JORDAN ROAD SW",
            "address_2": "SUITE 500",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683688",
            "telephone_number": "256-844-2825",
            "fax_number": "256-844-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "CARMELO",
        "middle_name": "CABALU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00017265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.