Individual provider Active NPI

Lisa J Mendez, PA

  • Surgical Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1114942638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA15428 Issued in CA
Practice address
2601 Oswell St
Suite
Bakersfield, CA 93306-3156
Phone
(661) 872-9999
Fax
(661) 872-1915
NPI assigned
Jul 13, 2006
Sex
Female
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
Surgical Physician Assistant 363AS0400X PA15428 CA Primary

Addresses

Primary practice location

2601 Oswell St
Suite
Bakersfield, CA 93306-3156

Mailing address

6009 Friedson CT
Bakersfield, CA 93306-9622
Phone (661) 872-0377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080619000757 CA Practitioner - Physician Assistant 4981775855 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emergency Physicians Urgent Care IncGroup PAC ID 8527234418, 138 clinicians

Practice addresses (Care Compare)

41540 Winchester Rd
Temecula, CA 92590-4877
Phone (951) 365-5585

6789 N Blackstone Ave
Fresno, CA 93710-3530
Phone (559) 512-3377

9710 Brimhall Rd
Bakersfield, CA 93312-2779
Phone (661) 829-6747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15428CAMDOccupational Therapist
PA15428CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp CurrentSince Nov 1, 2014 Accepting new patients
California Cardiac Surgeons - a Medical Group Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

Organizations & group practices 4

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114942638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 FRIEDSON CT",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933069622",
            "telephone_number": "661-872-0377",
            "fax_number": "661-872-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OSWELL ST",
            "address_2": "SUITE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063156",
            "telephone_number": "661-872-9999",
            "fax_number": "661-872-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA15428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.