Active NPI
Mayra Perez Mendoza, M.D.
- Pediatrics Physician
- Aguada, PR
National Provider Identifier
1154777332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 21402
- Practice address
- HC 58 Box 13527
Aguada, PR 00602-9893 - Phone
- (787) 231-6929
- NPI assigned
- May 6, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 21402 | PR | |
| Pediatrics Physician | 208000000X | 21402 | PR | Primary |
Addresses
Primary practice location
HC 58 Box 13527
Aguada, PR 00602-9893
Mailing address
HC 58 Box 13527
Aguada, PR 00602
Phone (787) 231-6929
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21402 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bella Vista Hospital Inc | Past | Accepting new patients | |
| Hospital San Carlos Incorporado | Past | Accepting new patients | |
| Hospital Comunitario Buen Samaritano Inc | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Mayaguez, PR
- NPI 1083636179
-
- General Acute Care Hospital
- Aguadilla, PR
- NPI 1922034776
-
- Rural Acute Care Hospital
- Moca, PR
- NPI 1104856889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1154777332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 58 BOX 13527",
"city": "AGUADA",
"state": "PR",
"postal_code": "00602",
"telephone_number": "787-231-6929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 58 BOX 13527",
"city": "AGUADA",
"state": "PR",
"postal_code": "006029893",
"telephone_number": "787-231-6929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ MENDOZA",
"first_name": "MAYRA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-06",
"last_updated": "2022-11-01",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "21402",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PR",
"license": "21402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aguada, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.