Kimberly Lynn Mendoza, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114084 Issued in FL

Practice address

2011 Harrison Ave
Panama City, FL 32405-4545

Phone

(850) 691-4188

Fax

(833) 687-1451

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313
• Jackson Hospital Hospital, Marianna, FL, CCN 100142

Merit-based Incentive Payment System (MIPS)

Final score

76.5 of 100Reported as group

Quality

47.27

Promoting interoperability

99

Improvement activities

40

Cost

75.24

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.mendoza.1@18802.direct.athenahealth.com

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.

• Tallahassee Orthopedic Clinic III PL

  • Medical Specialty Clinic/Center
  • Tallahassee, FL
  • NPI 1194778050
  Medicare reassignment Care Compare group NPD
• Tallahassee Orthopedic Clinic III, P.L.

  • Durable Medical Equipment & Medical Supplies
  • Panama City Beach, FL
  • NPI 1497617948
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Sacred Heart Gulf

  • Rural Acute Care Hospital
  • Port St Joe, FL
  • NPI 1083941678
  Care Compare affiliation
• Jackson County Hospital District

  • General Acute Care Hospital
  • Marianna, FL
  • NPI 1538108725
  Care Compare affiliation

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1174649933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GOSSAMER LN UNIT 7",
            "city": "INLET BEACH",
            "state": "FL",
            "postal_code": "324617051",
            "telephone_number": "703-964-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054545",
            "telephone_number": "850-691-4188",
            "fax_number": "833-687-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114084",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "23539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donavan Lea Melton, OTR/L
• Greta Melton, FNP
• Ross Richard Melvin, D.O.
• Ryan Daryl Melvin, D.O.
• Orlando J Mendez
• Aprill Mercer
• Deanna E Mercer, PHARMD
• Kevin Joseph Mercer, PHARMD, MPH
• Elimene J Merizier
• Jodi Ann Mertens, RMHCI

• Physician Assistant in Panama City, FL
• Providers in Panama City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.

Verify at the official NPI Registry.