Individual provider Active NPI

Krystle G Mendez

  • Physician Assistant
  • Perrysburg, OH
National Provider Identifier
1386218014
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003569A Issued in IN
Practice address
28863 Oregon Rd Apt G70
Perrysburg, OH 43551-3565
Phone
(219) 214-7446
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003569A IN Primary

Addresses

Primary practice location

28863 Oregon Rd Apt G70
Perrysburg, OH 43551-3565

Mailing address

28863 Oregon Rd Apt G70
Perrysburg, OH 43551-3565
Phone (219) 214-7446

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pic Indiana PC 143 clinicians

Practice addresses (Care Compare)

505 W Cleveland Rd
Mishawaka, IN 46545-1003
Phone (574) 235-3135

924 W Pike St
Physicians Urgent Care
Goshen, IN 46526-2365
Phone (574) 312-7056

Hospital & facility affiliations

  • Goshen Hospital Hospital, Goshen, IN, CCN 150026
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220902002729 IN Practitioner - Physician Assistant 5294119608 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003569AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jul 15, 2025 Accepting new patients
Cep America LLC CurrentSince Jul 15, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1386218014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28863 OREGON RD APT G70",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513565",
            "telephone_number": "219-214-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28863 OREGON RD APT G70",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513565",
            "telephone_number": "219-214-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "KRYSTLE",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003569A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.