Individual provider Active NPI

Selina Marie Mendes, PA-C

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1366049348
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2320 Issued in NV
Practice address
100 N Green Valley Pkwy Ste 235
Henderson, NV 89074-7704
Phone
(725) 333-8036
Fax
(702) 823-0316
NPI assigned
Oct 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA2320 NV Primary

Addresses

Primary practice location

100 N Green Valley Pkwy Ste 235
Henderson, NV 89074-7704

Mailing address

207 Del Cira Ave
Las Vegas, NV 89183-5603
Phone (860) 249-9228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021000819 NV Practitioner - Physician Assistant 5395165906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vera Whole Health Wa PC PastSince Jan 1, 2021 Accepting new patients
Vera Whole Health Wa PC Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: selina.mendes.1@32512.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1366049348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 DEL CIRA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835603",
            "telephone_number": "860-249-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY STE 235",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747704",
            "telephone_number": "725-333-8036",
            "fax_number": "702-823-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDES",
        "first_name": "SELINA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2024-03-15",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.