Individual provider Active NPI

Sandra C. Rojas Mendoza, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1467131136
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2318809 Issued in MA
Practice address
1290 Tremont St
Roxbury, MA 02120-3432
Phone
(617) 427-1000
NPI assigned
Jul 11, 2023
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2318809 MA Primary

Addresses

Primary practice location

1290 Tremont St
Roxbury, MA 02120-3432

Mailing address

1290 Tremont St
Roxbury, MA 02120-3432
Phone (617) 427-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20251211001615 MA Order and Referring Only - Nurse Practitioner 2668966128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2318809MAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: smendoza220792@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1467131136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 TREMONT ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021203432",
            "telephone_number": "617-427-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TREMONT ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021203432",
            "telephone_number": "617-427-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJAS MENDOZA",
        "first_name": "SANDRA",
        "middle_name": "C.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2318809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.