Fred P Mendoza, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33077 Issued in AZ

Practice address

1055 N. Lacanada Blvd
Suite 121
Green Valley, AZ 85614

Phone

(520) 547-7770

Fax

(520) 547-7775

NPI assigned

Oct 6, 2005

Sex

Male

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 AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fmendoza18373@azacp.direct-ci.com

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.

• Arizona Community Physicians PC

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1205871076
  Medicare reassignment NPD
• Arizona Community Physician PC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Tucson, AZ
  • NPI 1922141902
  NPD

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1316935042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD",
            "address_2": "SUITE A100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85711",
            "telephone_number": "520-382-1205",
            "fax_number": "520-795-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N. LACANADA BLVD",
            "address_2": "SUITE 121",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "85614",
            "telephone_number": "520-547-7770",
            "fax_number": "520-547-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "FRED",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871518",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dymphna I Medina, LMT
• Karla Medina, PT
• Medpsychplus LLC
• Georgette Mehalik, PNP
• Javier Anthony Mejia
• Matthew David Michaud, FNP
• Amanda Miklus, FNP-C
• MM&J Healthcare Services LLC (Beehive Homes of Green Valley)
• Mercedes Guadalupe Molina
• Efreim Joseph Morales

• Internal Medicine Physician in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.