Individual provider Active NPI

Gino Mendoza, M.D.

  • Specialist
  • Rockville, MD
National Provider Identifier
1093793671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0055152 Issued in MD
Practice address
4701 Randolph Rd
Suite 216
Rockville, MD 20852-2257
Phone
(301) 230-0888
Fax
(301) 230-9084
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0055152 MD Primary

Addresses

Primary practice location

4701 Randolph Rd
Suite 216
Rockville, MD 20852-2257

Mailing address

4701 Randolph Rd
Suite 216
Rockville, MD 20852-2257
Phone (301) 230-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20080423000655 DC Practitioner - Family Practice 4385722834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Primary Care, P.C.Group PAC ID 1557345931, 2 clinicians
Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

4701 Randolph Rd
Suite 216
Rockville, MD 20852-2257
Phone (301) 230-0888

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Largo, MD, CCN 217149
  • Adventist Home Health Services, Inc. Home health agency, Silver Spring, MD, CCN 217032

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Primary Care, P.C. CurrentSince Jan 1, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4701 Randolph Rd
Ste 216
Rockville, MD 20852
Phone (301) 230-0282

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093793671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "address_2": "SUITE 216",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522257",
            "telephone_number": "301-230-0888",
            "fax_number": "301-230-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "address_2": "SUITE 216",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522257",
            "telephone_number": "301-230-0888",
            "fax_number": "301-230-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "GINO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0055152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.