Frederick J Menick, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

11308 Issued in AZ

Practice address

1102 N El Dorado PL
Tucson, AZ 85715-4606

Phone

(520) 881-4525

Fax

(520) 881-2962

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2015 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Arran Industries

  • Plastic Surgery Physician
  • Tucson, AZ
  • NPI 1487233912
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427042233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 N EL DORADO PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154606",
            "telephone_number": "520-881-4525",
            "fax_number": "520-881-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 N EL DORADO PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154606",
            "telephone_number": "520-881-4525",
            "fax_number": "520-881-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENICK",
        "first_name": "FREDERICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "11308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22953501",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raquel Josefina Mendoza, FNP
• Samantha Mendoza
• Summer Lynn Mendoza, RD
• Sundai Marie Mendoza, LPN
• Arthur R Menezes, M.D.
• Menlo House
• Cheryl A. Mennel, CHERYL MENNEL
• Mental Health Resources Inc
• Mental Health Resources Inc (Housing Assistance for Arizona)
• Mentally Ill Kids in Distress

• Specialist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.