Bianca Mendoza, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD61335432 Issued in WA

Practice address

601 Government Rd
Mattawa, WA 99349-5120

Phone

(509) 488-5256

Fax

(509) 488-9939

NPI assigned

Aug 1, 2022

Last updated

Aug 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Basin Health AssociationGroup PAC ID 4486564309, 44 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Columbia Basin Health Association

  dba Eagle Eye Care

  • Federally Qualified Health Center (FQHC)
  • Connell, WA
  • NPI 1528316379
  Medicare reassignment Care Compare group NPD
• Columbia Basin Health Association

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1225716947
  NPD
• Columbia Basin Health Association

  • Federally Qualified Health Center (FQHC)
  • Mattawa, WA
  • NPI 1710232749
  NPD
• Columbia Basin Health Association

  • Federally Qualified Health Center (FQHC)
  • Othello, WA
  • NPI 1619915006
  NPD (past)

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1306572326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5250",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GOVERNMENT RD",
            "city": "MATTAWA",
            "state": "WA",
            "postal_code": "993495120",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Columbia Ave",
            "address_purpose": "LOCATION",
            "city": "Connell",
            "state": "WA",
            "postal_code": "993268702",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Othello",
            "state": "WA",
            "postal_code": "993441846",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "BIANCA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61335432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH LICENSE",
            "identifier": "OD61335432",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Jentges, APRN
• Cynthia A Johnson, CD
• Simar Kaur, ARNP
• Bryan Duane Larson, DNP-PMHNP
• Sonia Magana
• Cheryl Marie Mielbrecht, MS, PA-C
• Megan Pryce, RDH
• Cindy Luella Reed, ARNP, RN
• Erika Cecilia Ritchie
• Jenair Santos

• Optometrist in Mattawa, WA
• Providers in Mattawa, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.
• 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.