Individual provider Active NPI

Elvis Lester Mendoza Valle, MSN, APRN, AGNP-C

  • Primary Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1477419315
Registry record updated Jan 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AG01260001 Issued in KY
Practice address
11406 Caswell Springs Way
Louisville, KY 40291-8328
Phone
(502) 953-2657
NPI assigned
Jan 3, 2026
Last updated
Jan 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260511000811 KY Practitioner - Nurse Practitioner 0143798918 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
AG01260001KYMDPrimary 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

Verify at the official NPI Registry.