Individual provider Active NPI

Stephen L La Mendola, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Beaumont, TX
National Provider Identifier
1497863419
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
H8718 Issued in TX
Practice address
755 N 11TH St
Suite P2240
Beaumont, TX 77702-1500
Phone
(409) 899-4747
Fax
(409) 899-4881
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X H8718 TX Primary

Addresses

Primary practice location

755 N 11TH St
Suite P2240
Beaumont, TX 77702-1500

Mailing address

755 N 11TH St
Suite P2240
Beaumont, TX 77702-1500
Phone (409) 899-4747

Other identifiers 1

IdentifierTypeStateIssuer
118886402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101122001271 TX Practitioner - Thoracic SurgeryPractitioner - General Surgery 8820195829 Reassigns benefits to 2 organizations
I20210707004018 LA Practitioner - Thoracic SurgeryPractitioner - General Surgery 8820195829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Feb 1, 2025 Accepting new patients

Locations

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3070 College St
Ste 100
Beaumont, TX 77701
Phone (409) 212-6280

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1497863419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P2240",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021500",
            "telephone_number": "409-899-4747",
            "fax_number": "409-899-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P2240",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021500",
            "telephone_number": "409-899-4747",
            "fax_number": "409-899-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA MENDOLA",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "H8718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118886402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.