Individual provider Active NPI

Jhonatan Leal Mendoza, MD

  • Family Medicine Physician
  • Delano, CA
National Provider Identifier
1215420047
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A173697 Issued in CA
Practice address
425 Del Sol Pkwy
Delano, CA 93215-3442
Phone
(661) 720-4011
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A173697 CA Primary

Addresses

Primary practice location

425 Del Sol Pkwy
Delano, CA 93215-3442

Mailing address

PO Box 1559
Bakersfield, CA 93302-1559
Phone (661) 635-3050

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210816004122 CA Practitioner - Family Practice 5799184479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

2000 Physicians Blvd
Bakersfield, CA 93301-1277
Phone (661) 324-1455

Hospital & facility affiliations

  • Purpose Driven Home Health, LLC Home health agency, Bakersfield, CA, CCN 059545
  • Gifted Arms Home Healthcare Services Home health agency, Bakersfield, CA, CCN 059248
  • Adventist Health Delano Hospital, Delano, CA, CCN 050608
  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A173697CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Aug 6, 2021 Accepting new patients
Clinica Sierra Vista Current Accepting new patients
Clinica Sierra Vista CurrentSince Aug 6, 2021 Accepting new patients
Clinica Sierra Vista Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Stepanyan PastSince May 31, 2020 Accepting new patients
Family Practice of Glendale a Medical Corporation Family Medicine PastSince May 31, 2020 Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

2000 Physicians Blvd
Bakersfield, CA 93301
Phone (661) 324-1455

425 Del Sol Pkwy
Delano, CA 93215
Phone (661) 720-4011

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1215420047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021559",
            "telephone_number": "661-635-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DEL SOL PKWY",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932153442",
            "telephone_number": "661-720-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAL MENDOZA",
        "first_name": "JHONATAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delano, CA

Sources for this page

Verify at the official NPI Registry.