Alysia Anne Mendoza, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1200 Childrens Ave Ste 14000
Oklahoma City, OK 73104-4637

Phone

(405) 271-4407

NPI assigned

May 30, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alysia Anne Brooks Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amendoza376009@direct-ehr-ssmhc.com

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.

• Saints Medical Group, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437195922
  Medicare reassignment NPD
• Saints Medical Group, LLC

  dba SSM Health Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Edmond, OK
  • NPI 1730907700
  NPD
• St Anthony Shawnee Hospital Inc

  dba St Anthony Shawnee Hospital

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083142459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "580-916-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE STE 14000",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "ALYSIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-07-21",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSIA",
            "last_name": "BROOKS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mending Hearts LLC
• Michaelyn Dawn Mendiola
• Tasia Victoria Mendiola, LPC
• Julia Mendonca
• Abel Mendoza, MSN, APRN, AGCNS- BC
• Christina Mendoza
• Daniel Robert Mendoza
• Kaitlyn Bianca Mendoza
• Sophia Alejandra Mendoza, BA
• Caitlin Menjivar

• Student in an Organized Health Care Education/Training Program in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Student in an Organized Health Care Education/Training Program in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.