Individual provider Active NPI

Aubrey A Mendoza, PA-C

  • Physician Assistant
  • Amsterdam, NY
National Provider Identifier
1386375657
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4104 State Highway 30
Amsterdam, NY 12010-6202
Phone
(518) 883-8634
Fax
(518) 883-8286
NPI assigned
Jun 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 NY Primary

Addresses

Primary practice location

4104 State Highway 30
Amsterdam, NY 12010-6202

Mailing address

106 Burton St
Johnstown, NY 12095-2023

Other practice location 1

231 Union St Apt 1
Schenectady, NY 12305-1423
Phone (518) 774-2166

Other names 1

  • Aubrey Stegel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220929002360 NY Practitioner - Physician Assistant 9436535325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028404NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Littauer Hospital Association CurrentSince Jul 25, 2022 Accepting new patients
Nathan Littauer Hospital & Nursing Home CurrentSince Jul 25, 2022 Accepting new patients
Nathan Littauer Hospital Association Past Accepting new patients

Locations

4104 State Highway 30
Amsterdam, NY 12010
Phone (518) 883-8620

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1655510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1386375657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BURTON ST",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120952023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120106202",
            "telephone_number": "518-883-8634",
            "fax_number": "518-883-8286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Union St Apt 1",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123051423",
            "country_code": "US",
            "telephone_number": "518-774-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "AUBREY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-18",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUBREY",
            "last_name": "STEGEL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.