Phillip Mendoza MD, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PHILLIP MENDOZA MD, LLC

Practice address

20 S 5TH Ave Ste D
Brighton, CO 80601-2179

Phone

(303) 960-7516

NPI assigned

Oct 5, 2021

Organization subpart

No

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

Authorized official

Name

Phillip Mendoza, MDNPI 1760681761

Title

Physician Owner

Phone

(303) 960-7516

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, AK2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24486/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Mendoza, MD

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1760681761

  AK, CO

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1336801562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S 5TH AVE STE D",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012179",
            "telephone_number": "303-960-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S 5TH AVE STE D",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012179",
            "telephone_number": "303-960-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP MENDOZA MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "303-960-7516",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Sue Peterson, CPM,RM
• Cory R Peticolas, FNP-C
• Katrina Le Pham, PT, DPT
• Eliza Claire Pharis
• Shobha Philip
• Rebecca Sholeh Philman, RN
• Phyhealth Sleep Care Colorado Inc
• Ryan Piersall
• Christine M Pigott, MD
• Monica R Plaskey, NP-C

• All providers in Brighton, CO
• Health Service Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.