Individual provider Active NPI

Jaime Mencke, MD

  • General Practice Physician
  • Bethesda, MD
National Provider Identifier
1053179465
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101287044 Issued in VA
Practice address
8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone
(301) 319-8754
NPI assigned
Mar 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101287044 VA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Bethesda, MD 20889-0001

Mailing address

8901 Wisconsin Ave
Bethesda, MD 20889-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20250823000324 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3971003096

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1053179465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-319-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENCKE",
        "first_name": "JAIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101287044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.