Active NPI
Esmeralda C Mendez, CG61416144
- Peer Specialist
- Othello, WA
National Provider Identifier
1124728522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- WDL462P9463B
- Practice address
- 425 E Main St Ste 600
Othello, WA 99344-1146 - Phone
- (509) 488-5611
- NPI assigned
- Mar 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | WDL462P9463B | WA | Primary |
Addresses
Primary practice location
425 E Main St Ste 600
Othello, WA 99344-1146
Mailing address
1000 E Mt Baker St
Othello, WA 99344-5509
Phone (509) 346-0118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WDL462P9463B | WA | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Adams | Past | Accepting new patients | |
| County of Adams | Peer Specialist | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Othello, WA
- NPI 1487905154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1124728522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E MT BAKER ST",
"city": "OTHELLO",
"state": "WA",
"postal_code": "993445509",
"telephone_number": "509-346-0118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 E MAIN ST STE 600",
"city": "OTHELLO",
"state": "WA",
"postal_code": "993441146",
"telephone_number": "509-488-5611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ",
"first_name": "ESMERALDA",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "CG61416144",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-06",
"last_updated": "2023-03-06",
"certification_date": "2023-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WA",
"license": "WDL462P9463B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Othello, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.