Individual provider Active NPI

German Eduardo Mendoza, M.D.

  • Surgery Physician
  • Omaha, NE
National Provider Identifier
1104279314
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
7693 Issued in NE
Practice address
601 N. 30TH St. - Cu Dept of Surgery
Omaha, NE 68131-2128
Phone
(402) 280-4669
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X T5169 TX
Surgery Physician 208600000X 7693 NE Primary

Addresses

Primary practice location

601 N. 30TH St. - Cu Dept of Surgery
Omaha, NE 68131-2128

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-4997

Other practice location 1

1010 S Ponds Dr
Webster, TX 77598-1409
Phone (713) 442-4300

Other practice location 2

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

Other practice location 3

5001 E Sam Houston Pkwy S
Pasadena, TX 77505-3965
Phone (713) 442-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220805000352 TX Practitioner - General Surgery 2961768619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7693NEMDMental Health Counselor
T5169TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Sep 19, 2022 Accepting new patients
KS SC LLC PastSince Jan 28, 2024 Accepting new patients

Locations

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

5001 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 442-7100

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

18833 Eastfield Dr
Webster, TX 77598
Phone (713) 442-4300

1010 S Ponds Dr
Webster, TX 77598
Phone (713) 442-4300

Interoperability endpoints

  • Direct secure messaging: gmendoza45304@direct.kelsey-seybold.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1104279314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N. 30TH ST. - CU DEPT OF SURGERY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312128",
            "telephone_number": "402-280-4669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 S Ponds Dr",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775981409",
            "country_code": "US",
            "telephone_number": "713-442-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2727 W Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770251669",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5001 E Sam Houston Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775053965",
            "country_code": "US",
            "telephone_number": "713-442-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "GERMAN",
        "middle_name": "EDUARDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "T5169",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "7693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.