Individual provider Active NPI

Gloria Isabel Mendez, PH.D.

  • Psychologist
  • Christiansted, VI
National Provider Identifier
1326134644
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
98-005PSY Issued in VI
Practice address
7 Church St
Christiansted, VI 00820-4602
Phone
(340) 773-3322
Fax
(340) 773-2566
NPI assigned
Oct 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 98-005PSY VI Primary

Addresses

Primary practice location

7 Church St
Christiansted, VI 00820-4602

Mailing address

7 Church St
Christiansted, VI 00820-4602
Phone (340) 773-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200729003933 VI Practitioner - Clinical Psychologist 1759706369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lindsy Wagner LLCGroup PAC ID 3476800574, 16 clinicians

Practice addresses (Care Compare)

5030 Anchor Way
Christiansted, VI 00820-4692
Phone (340) 719-7007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98-005PSYVIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsy Wagner LLC CurrentSince Jul 20, 2020 Accepting new patients
Lindsy Wagner LLC PastSince Oct 17, 2021 Accepting new patients
Lindsy Wagner LLC PastSince Sep 20, 2020 Accepting new patients

Locations

5030 Anchor Way
Ste 7
Christiansted, VI 00820
Phone (973) 280-4006

Organizations & group practices 3

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326134644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CHURCH ST",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008204602",
            "telephone_number": "340-773-3322",
            "fax_number": "340-773-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CHURCH ST",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008204602",
            "telephone_number": "340-773-3322",
            "fax_number": "340-773-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "GLORIA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VI",
            "license": "98-005PSY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansted, VI

Sources for this page

Verify at the official NPI Registry.