Mission Urology, Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

MISSION UROLOGY, INC.

Practice address

4500 Brockton Ave
Suite 301
Riverside, CA 92501-4027

Phone

(951) 276-4505

Fax

(951) 276-4517

NPI assigned

Mar 24, 2016

Organization subpart

No

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

Authorized official

Name

Jo-Ann Mendoza, MD

Title

President

Phone

(951) 276-4505

Specialties & licenses 2

Addresses

Other names 1

• Mission Urology Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ken Takesita, M.D.

  • Urology Physician
  • Riverside, CA
  • NPI 1629243837
  Medicare reassignment NPD
• Sy Tsi, MD

  • Urology Physician
  • Corona, CA
  • NPI 1194743864
  Medicare reassignment NPD

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1063874337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7270",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925527270",
            "telephone_number": "951-656-1500",
            "fax_number": "951-656-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE",
            "address_2": "SUITE 301",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014027",
            "telephone_number": "951-276-4505",
            "fax_number": "951-276-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION UROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-24",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "JO-ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-276-4505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mission Medical Associates, Inc.
• Mission Medical Clinic
• Mission Surgical Center Inc
• Mission Surgical Clinic, Inc.
• Mission Surgical Group
• Felicia A Mitchell Payton, LMFT
• Amber Mitchell, CHW
• Barbara Jean Mitchell, LCSW
• Cherie Lynn Mitchell
• Corey Mitchell

• Urology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.