Active NPI
Aileen Mendoza, PA-C
- Physician Assistant
- Greeley, CO
National Provider Identifier
1134701923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 5890 W 13TH St Ste 101
Greeley, CO 80634-4821 - Phone
- (970) 810-0020
- NPI assigned
- Apr 22, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
5890 W 13TH St Ste 101
Greeley, CO 80634-4821
Mailing address
4175 Pennycress Dr
Johnstown, CO 80534-8242
Phone (970) 556-5184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210520001544 | CO | Practitioner - Physician Assistant | 6608275839 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121
5890 W 13TH St
Greeley, CO 80634-4821
Hospital & facility affiliations
- Banner North Colorado Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Health Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Health Physicians Colorado LLC | Current | Accepting new patients | |
| Banner Health Physicians Colorado LLC | Past | Accepting new patients |
Locations
5890 W 13th St
Ste 101
Greeley, CO 80634
Phone (970) 348-0020
1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121
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.
-
- Multi-Specialty Clinic/Center
- Torrington, WY
- NPI 1215375688
-
- Multi-Specialty Clinic/Center
- Windsor, CO
- NPI 1831476381
Hospital & facility affiliations 12
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": "1619049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619049600000",
"number": "1134701923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4175 PENNYCRESS DR",
"city": "JOHNSTOWN",
"state": "CO",
"postal_code": "805348242",
"telephone_number": "970-556-5184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5890 W 13TH ST STE 101",
"city": "GREELEY",
"state": "CO",
"postal_code": "806344821",
"telephone_number": "970-810-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "AILEEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-22",
"last_updated": "2021-04-22",
"certification_date": "2021-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.