Ciriaco Ada Mendoza, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

13884 Issued in WV

Practice address

122 12TH Street Ext
Princeton, WV 24740-2352

Phone

(304) 487-7000

NPI assigned

Jun 9, 2006

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 4

Medicare fee-for-service enrollment

Enrolled in WV

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

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.

• Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
  • NPI 1568401461
  Medicare reassignment NPD
• Elm Emergency Group PLLC

  • Emergency Medicine Physician
  • Logan, WV
  • NPI 1447400734
  NPD (past)
• Epmg of Virginia P C

  • Emergency Medical Services (Emergency Medicine) Physician
  • Blacksburg, VA
  • NPI 1972545531
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1376584508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634715",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402352",
            "telephone_number": "304-487-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "CIRIACO",
        "middle_name": "ADA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "13884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000699368",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052156-000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00048451",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "1044421",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Alyse Meadows, FNP-BC
• Michael Meadows, PR
• Misty Lee Meadows, PA-C
• Med-Response, Inc.
• Medical Renal Group
• Mercer County Commission on Aging, Inc
• Mercer County Commission on Aging, Inc.
• Mercer County Opportunity Industries, Inc.
• Mercer Hope Connections LLC
• Susan C Meredith, BC-HIS, ACA

• Emergency Medicine Physician in Princeton, WV
• Providers in Princeton, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.