Individual provider Active NPI

Renier Rosquete Mendez, MD

  • Family Medicine Physician
  • West Covina, CA
National Provider Identifier
1285110635
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A173730 Issued in CA
Practice address
1115 S Sunset Ave # 2
West Covina, CA 91790-3940
Phone
(626) 813-2850
NPI assigned
Jul 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A173730 CA Primary

Addresses

Primary practice location

1115 S Sunset Ave # 2
West Covina, CA 91790-3940

Mailing address

1115 S Sunset Ave # 2
West Covina, CA 91790-3940

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
I20220419001097 CA Practitioner - Family Practice 7719374982 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John a Fagan MD Family Practice IncGroup PAC ID 4880764471, 2 clinicians

Practice addresses (Care Compare)

10787 Laurel St
Rancho Cucamonga, CA 91730-3828
Phone (909) 982-7741

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A173730CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnext Management LLC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
John a Fagan MD Family Practice Inc CurrentSince May 25, 2024 Accepting new patients
East Valley Community Health Center, Inc. CurrentSince Mar 23, 2022 Accepting new patients
East Valley Community Health Center, Inc. Current Accepting new patients

Locations

1555 S Garey Ave
Pomona, CA 91766
Phone (909) 620-8088

10787 Laurel St
Rch Cucamonga, CA 91730
Phone (909) 982-7741

250 E Easy St
Ste 4A
Simi Valley, CA 93065
Phone (805) 422-8086

420 S Glendora Ave
West Covina, CA 91790
Phone (626) 919-5724

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHDFCA/Endpoint/GHDFCA

Organizations & group practices 4

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1285110635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE # 2",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE # 2",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-813-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSQUETE MENDEZ",
        "first_name": "RENIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.