NPIMap

Individual provider Active NPI

Marco Mendoza, M.D.

  • Orthopaedic Surgery Physician
  • Carson City, NV
National Provider Identifier
1255627964
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
17066 Issued in NV
Practice address
973 Mica Dr
Suite 201
Carson City, NV 89705-7255
Phone
(775) 783-6190
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125059818 IL
Orthopaedic Surgery Physician 207X00000X 2016-00148 NC
Orthopaedic Surgery Physician 207X00000X 17066 NV Primary
Orthopaedic Surgery Physician 207X00000X A149150 CA

Addresses

Primary practice location

973 Mica Dr
Suite 201
Carson City, NV 89705-7255

Mailing address

973 Mica Dr
Suite 201
Carson City, NV 89705-7255
Phone (775) 783-6190

Other practice location 1

2170B
South Lake Tahoe, CA 96150-3465
Phone (775) 783-6190

Other identifiers 2

IdentifierTypeStateIssuer
1255627964MedicaidNC
NC2672MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NV, CA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160518002299 NC Practitioner - Orthopedic Surgery 2668776642 Reassigns benefits to 1 organization
I20170707002653 NV Practitioner - Orthopedic Surgery 2668776642 Reassigns benefits to 1 organization
I20170720000804 CA Practitioner - Orthopedic Surgery 2668776642

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Kentucky College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
James J Lynch M D LTDGroup PAC ID 9133188626, 81 clinicians
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians

Practice addresses (Care Compare)

10539 Professional Cir
Suite 201
Reno, NV 89521-3858
Phone (775) 793-6190

1470 Medical Pkwy
Suite 220
Carson City, NV 89703-4647
Phone (775) 348-8800

2874 N Carson St
Suite 123
Carson City, NV 89706-1681
Phone (775) 783-6190

440 E Golden Valley Rd
Reno, NV 89506-5722
Phone (775) 360-3000

7700 Rancharrah Pkwy
Suite 100
Reno, NV 89511-7659
Phone (775) 348-8800

780 Vista Blvd
Suite 100
Sparks, NV 89434-6677
Phone (775) 348-8800

961 Mica Dr
Carson City, NV 89705-7269
Phone (775) 348-8800

973 Mica Dr
Suite 201
Carson City, NV 89705-7258
Phone (775) 783-6190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion119
Laminectomy or laminotomy (partial removal of spine bones)55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149150CAMDMarriage & Family Therapist
17066NVMDPharmacist
A149150CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Aug 1, 2016 Accepting new patients
James J Lynch M D LTD Orthopaedic Surgery CurrentSince Jan 1, 2022 Accepting new patients
James J Lynch MD LTD CurrentSince Jan 1, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Aug 1, 2016 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Barton Healthcare System PastSince Aug 1, 2026 Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients

Locations

2170 South Ave
#B
South Lake Tahoe, CA 96150
Phone (530) 539-6620

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1749 N Stewart St
Ste 50
Carson City, NV 89706
Phone (775) 392-3689

2874 N Carson St
Ste 123
Carson City, NV 89706

973 Mica Dr
Ste 201
Carson City, NV 89705
Phone (702) 884-5470

2874 N Carson St
Ste 105
Carson City, NV 89706
Phone (775) 283-3321

1470 Medical Pkwy
Ste 220
Carson City, NV 89703

7700 Rancharrah Pkwy
Ste 100
Reno, NV 89511

10381 Double R Blvd
Reno, NV 89521
Phone (775) 322-1200

595 Mount Rose St
Reno, NV 89509
Phone (775) 323-3660

825 S Meadows Pkwy
Ste 102
Reno, NV 89521

1465 S Meadows Pkwy
Reno, NV 89521
Phone (775) 348-8885

9480 Double Diamond Pkwy
Ste 200
Reno, NV 89521
Phone (775) 348-8000

10539 Professional Cir
Ste 201
Reno, NV 89521
Phone (775) 674-5632

9990 Double R Blvd
Ste 200
Reno, NV 89521
Phone (753) 488-8008

780 Vista Blvd
Ste 100
Sparks, NV 89434
Phone (753) 348-8800

780 Vista Blvd
Ste 101
Sparks, NV 89434

Interoperability endpoints

  • Direct secure messaging: marco.mendoza.1@22724.direct.athenahealth.com

Organizations & group practices 10

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 8

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1255627964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 MICA DR",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 MICA DR",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2170B",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961503465",
            "country_code": "US",
            "telephone_number": "775-783-6190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARCO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2021-08-11",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125059818",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2016-00148",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "17066",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A149150",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255627964",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2672",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.