Micaela Angela Mendietta

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1367179 Issued in TX

Practice address

410 N Palafox St
Pensacola, FL 32501-3919

Phone

(850) 458-2020

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, FL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Physical Therapy LLCGroup PAC ID 2769915347, 25 clinicians

Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Action Therapy Group LLC

  • Physical Therapist
  • Jay, FL
  • NPI 1548861602
  Medicare reassignment Care Compare group NPD
• Novant Health Physical Therapy LLC

  dba Novant Health Physical Therapy

  • Physical Therapist
  • Port Royal, SC
  • NPI 1376379818
  Medicare reassignment Care Compare group NPD
• Legendary Physical Therapy LLC

  dba Legendary Physical Therapy and Wellness Center

  • Physical Therapist
  • Pensacola, FL
  • NPI 1578089983
  Medicare reassignment NPD
• Dynamic Physical Therapy & Rehabilitation

  • Physical Therapist
  • Fort Mill, SC
  • NPI 1164626925
  NPD (past)
• Dynamic Physical Therapy & Rehabilitation Center LLC

  • Physical Therapist
  • Florence, SC
  • NPI 1346334570
  NPD (past)

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1487373544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E MAIN ST",
            "city": "BISHOP",
            "state": "TX",
            "postal_code": "783432650",
            "telephone_number": "361-355-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013919",
            "telephone_number": "850-458-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 S Cashua Dr",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295014001",
            "country_code": "US",
            "telephone_number": "843-292-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDIETTA",
        "first_name": "MICAELA",
        "middle_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1367179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Melton
• Sheila Annette Melvin, ARNP
• Michelle Melzer
• Cathleen A Menda, LMHC
• Mended Wing Counseling, LLC
• Mending Hands Healthcare Agency, LLC
• Alexis Mendoza
• Matthew Mendoza, DC
• Elida Pacheco Meneses, RMHCI
• Reed William Menger, DPT

• Physical Therapist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.