Carolyn L. Mendiola Fruge, MSN. AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP-0198 Issued in GU

Practice address

1244 N Marine Corps Dr
Tamuning, GU 96913-4308

Phone

(671) 647-8262

Fax

(671) 647-5252

NPI assigned

Apr 28, 2019

Last updated

Apr 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GU

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Medical Center, LLC

  • Urgent Care Clinic/Center
  • Upper Tumon, GU
  • NPI 1457329849
  Medicare reassignment

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556409600000",
    "number": "1205490992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7358",
            "city": "AGAT",
            "state": "GU",
            "postal_code": "969280358",
            "telephone_number": "671-487-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-647-8262",
            "fax_number": "671-647-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUGE",
        "first_name": "CAROLYN",
        "middle_name": "L. MENDIOLA",
        "name_prefix": "Mrs.",
        "credential": "MSN. AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-28",
        "last_updated": "2019-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GU",
            "license": "NP-0198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Denise Flores, M.D.
• Eric J. Fly, PA-C
• Milliecor Itugot Fojas, M.D.
• Brian Scott Ford, M.D.
• Samuel Friedman, M.D.
• Gerren Christopher Gabriel
• Mildred Maniago Gabriel, RPH
• Renato C. Gahol, M.D.
• Geoffrey Perpetua Galgo, DOCTOR OF MEDICINE
• Anna Lou Caranay Garces, GENRAL MANAGER

• Gerontology Nurse Practitioner in Tamuning, GU
• Providers in Tamuning, GU by specialty
• Gerontology Nurse Practitioner in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2019; 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.