Active NPI
Elvis Lester Mendoza Valle, MSN, APRN, AGNP-C
- Primary Care Nurse Practitioner
- Louisville, KY
National Provider Identifier
1477419315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- AG01260001
- Practice address
- 11406 Caswell Springs Way
Louisville, KY 40291-8328 - Phone
- (502) 953-2657
- NPI assigned
- Jan 3, 2026
- Last updated
- Jan 3, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | AG01260001 | KY | Primary |
Addresses
Primary practice location
11406 Caswell Springs Way
Louisville, KY 40291-8328
Mailing address
11406 Caswell Springs Way
Louisville, KY 40291-8328
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
4055 Valley View LN
Suite 700
Dallas, TX 75244-5045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AG01260001 | KY | MD | Primary Care Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767398400000",
"number": "1477419315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11406 CASWELL SPRINGS WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402918328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11406 CASWELL SPRINGS WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402918328",
"telephone_number": "502-953-2657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA VALLE",
"first_name": "ELVIS",
"middle_name": "LESTER",
"credential": "MSN, APRN, AGNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-01-03",
"last_updated": "2026-01-03",
"certification_date": "2026-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "KY",
"license": "AG01260001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.