Active NPI
Theresa Ann Marie Mendes, PA-C
- Physician Assistant
- Stuart, FL
National Provider Identifier
1467185769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9119078
- Practice address
- 433 SE Ocean Blvd
Stuart, FL 34994-2573 - Phone
- (772) 276-7242
- NPI assigned
- Jul 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 9119078 | FL | Primary |
Addresses
Primary practice location
433 SE Ocean Blvd
Stuart, FL 34994-2573
Mailing address
320 SE Fascino Cir
Port St Lucie, FL 34984-6634
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9119078 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1467185769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 SE FASCINO CIR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349846634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 SE OCEAN BLVD",
"city": "STUART",
"state": "FL",
"postal_code": "349942573",
"telephone_number": "772-276-7242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDES",
"first_name": "THERESA ANN",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-05",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9119078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.