Patricio Mendoza, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6098830-8900 Issued in UT

Practice address

6489 W Rivulet Rd
Herriman, UT 84096-1421

Phone

(801) 699-5629

NPI assigned

Jan 10, 2022

Sex

Male

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 UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patricio.mendoza@736943059828740.direct.elationemr.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.

• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1184375370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6489 W RIVULET RD",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840961421",
            "telephone_number": "801-699-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6489 W RIVULET RD",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840961421",
            "telephone_number": "801-699-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "PATRICIO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6098830-4405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "6098830-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tess Marlene McInelly
• Alison McLennan, RBT
• Corinne Meikle, LSUDC
• Donna R Melton, OD
• Sarah Mendez
• Saralyn Messegee
• Michael D Rosvall, DDS Ms, Inc
• Michael J. Peterson M.D LLC
• Sean A Miller, MPT
• Mindful Wellness Solutions, LLC

• Nurse Practitioner in Herriman, UT
• Providers in Herriman, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.