Individual provider Active NPI

Diana Yvonne Mendez

  • Orthopedic Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1306536511
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
1952 E Fort Union Blvd
Salt Lake City, UT 84121-6877
Phone
(801) 942-3311
NPI assigned
May 10, 2023
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

1952 E Fort Union Blvd
Salt Lake City, UT 84121-6877

Mailing address

2457 S 300 E Apt 2
South Salt Lake, UT 84115-3263
Phone (310) 251-6378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016001913 CA Practitioner - Physical Therapist in Private Practice 0749635498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tag Physical Therapy IncGroup PAC ID 6103834171, 16 clinicians

Practice addresses (Care Compare)

501 Deep Valley Dr
Suite 200
Rolling Hills Estates, CA 90274-7608
Phone (310) 426-9570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tag Physical Therapy, Inc Orthopedic CurrentSince Aug 26, 2023 Accepting new patients

Locations

501 Deep Valley Dr
Ste 200
Rolling Hills Estates, CA 90274
Phone (310) 377-0710

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1306536511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2457 S 300 E APT 2",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153263",
            "telephone_number": "310-251-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 E FORT UNION BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216877",
            "telephone_number": "801-942-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "DIANA",
        "middle_name": "YVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.