Jeffrey A. Mendoza, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101021421 Issued in MI

Practice address

11775 Tecumseh Clinton Rd
Clinton, MI 49236-9541

Phone

(517) 456-7449

Fax

(517) 456-6059

NPI assigned

Jun 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
• Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Family Medicine Physician
  • Clinton, MI
  • NPI 1992852594
  NPD
• Iha Health Services Corporation

  • Family Medicine Physician
  • Milan, MI
  • NPI 1467509067
  NPD (past)

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

• Emma L. Bixby Medical Center

  • General Acute Care Hospital
  • Adrian, MI
  • NPI 1972564730
  Care Compare affiliation
• Great Lakes Home Health Services, Inc.

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation
• St Joseph Mercy Chelsea Inc

  • General Acute Care Hospital
  • Chelsea, MI
  • NPI 1992761985
  Care Compare affiliation
• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1073807665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11775 TECUMSEH CLINTON RD",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "492369541",
            "telephone_number": "517-456-7449",
            "fax_number": "517-456-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116023323",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101021421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Steven Kosmyna, DC
• Adam Kosteva, MD
• Caitlin Kriengkrairut
• Richard Kruse
• David Randolph Levitsky, DPM
• Jamie Mercer
• Susan Mullinix, PT
• Nicholas J Pelachyk DDS PC
• Per Okey, M.D.
• Carlene Oliver

• Family Medicine Physician in Clinton, MI
• Providers in Clinton, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.
• 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.