NPIMap

Organization Active NPI

Ernesto Mendoza M.D.

  • Surgery Physician
  • Elmhurst, NY
National Provider Identifier
1194049296
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
152994 Issued in NY
Legal business name
ERNESTO MENDOZA M.D.
Practice address
4045 78TH St
Elmhurst, NY 11373-1152
Phone
(718) 397-9058
NPI assigned
Mar 17, 2010
Last updated
Mar 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Ernesto Mendoza, M.D.NPI 1770593972
Title
President
Phone
(718) 397-9058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 152994 NY Primary

Addresses

Primary practice location

4045 78TH St
Elmhurst, NY 11373-1152

Mailing address

4045 78TH St
Elmhurst, NY 11373-1152

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1194049296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 78TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 78TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731152",
            "telephone_number": "718-397-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNESTO MENDOZA M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-397-9058",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "152994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.