Organization Active NPI

Tamara Mendez OD LLC

  • Optometrist
  • Chevy Chase, MD
National Provider Identifier
1508488123
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TAMARA MENDEZ OD LLC
Practice address
8401 Connecticut Ave Ste 102
Chevy Chase, MD 20815-5820
Phone
(240) 626-3461
NPI assigned
May 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Authorized official

Name
Dr. Tamara Mendez, OD
Title
Optometrist / Owner
Phone
(240) 626-3461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

8401 Connecticut Ave Ste 102
Chevy Chase, MD 20815-5820

Mailing address

12400 Park Potomac Ave Apt 404
Potomac, MD 20854-6987
Phone (240) 626-3461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200715001479 DC Part B Supplier - Clinic/Group Practice 1254754849 Receives reassigned benefits from 1 practitioner
Practice locations: Chevy Chase, MD

National Provider Directory

National Provider Directory

Locations

8401 Connecticut Ave
Ofc
Chevy Chase, MD 20815
Phone (240) 626-3461

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589760000000",
    "number": "1508488123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 PARK POTOMAC AVE APT 404",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546987",
            "telephone_number": "240-626-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE STE 102",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155820",
            "telephone_number": "240-626-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMARA MENDEZ OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OPTOMETRIST / OWNER",
        "authorized_official_telephone_number": "240-626-3461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.