Individual provider Active NPI

Alexis Mendez, OD

  • Optometrist
  • Moreno Valley, CA
National Provider Identifier
1184215543
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT34742-TLG Issued in CA
Practice address
23000 Atlantic Cir
Moreno Valley, CA 92553-5990
Phone
(951) 924-1877
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT34742-TLG CA Primary

Addresses

Primary practice location

23000 Atlantic Cir
Moreno Valley, CA 92553-5990

Mailing address

3410 Farm LN
Perris, CA 92571-7614

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210326002102 CA Practitioner - Optometry 5193132702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Ragsdale and Clayton Optometric Centers IncGroup PAC ID 9537381132, 3 clinicians

Practice addresses (Care Compare)

23000 Atlantic Cir
Moreno Valley, CA 92553-5990
Phone (951) 924-1877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT34742-TLGCAMDOptometrist
34742CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Ragsdale & Clayton Optometric Centers, Inc. Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Claravision Optometry Optometrist Current Accepting new patients

Locations

23000 Atlantic Cir
Moreno Valley, CA 92553
Phone (951) 924-1877

3674 Sunnyside Dr
Ste 2
Riverside, CA 92506
Phone (951) 684-4646

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.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1184215543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 FARM LN",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925717614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 ATLANTIC CIR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535990",
            "telephone_number": "951-924-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "ALEXIS",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT34742-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.