Individual provider Active NPI

Jacqueline Mendoza Babol, DPM

  • Podiatrist
  • Spokane, WA
National Provider Identifier
1528050994
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000715 Issued in WA
Practice address
205 N University
#4
Spokane, WA 99206
Phone
(509) 928-8181
Fax
(208) 772-9949
NPI assigned
Aug 22, 2005
Reactivated
Sep 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO00000715 WA Primary
Podiatrist 213E00000X P218 ID

Addresses

Primary practice location

205 N University
#4
Spokane, WA 99206

Mailing address

9116 E Sprague Ave
#278
Spokane, WA 99206
Phone (509) 928-8181

Other identifiers 1

IdentifierTypeStateIssuer
1116623MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120104000112 WA Practitioner - Podiatry 1355245424 Reassigns benefits to 1 organization
I20151118003153 ID Practitioner - Podiatry 1355245424 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Clinic of Spokane Inc CurrentSince May 1, 2003 Accepting new patients
Foot and Ankle Clinic of Spokane Inc CurrentSince May 1, 2002 Accepting new patients
Foot and Ankle Clinic of Spokane Inc PastSince May 9, 2003 Accepting new patients
Foot and Ankle Clinic of Spokane Inc Podiatrist PastSince May 9, 2003 Accepting new patients
Foot & Ankle Clinic of Spokane Past Accepting new patients

Locations

6848 N Government Way
#1142
Dalton Gardens, ID 83815

8944 N Hess St
#A
Hayden, ID 83835
Phone (208) 500-0601

8836 N Hess St
Ste C
Hayden, ID 83835
Phone (208) 762-0909

205 N University Rd
Ste 5
Spokane Valley, WA 99206
Phone (509) 928-8181

9116 E Sprague Ave
Spokane Valley, WA 99206
Phone (509) 655-2242

205 N University Rd
Ste 4
Spokane Valley, WA 99206
Phone (509) 928-8181

Interoperability endpoints

  • Direct secure messaging: jbabol@faac-wa.direct.office.nextgen.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 N University Rd
Spokane Valley, WA 99206-5094
Phone (509) 928-8181

8836 N Hess St
Suite C
Hayden, ID 83835-8718
Phone (208) 762-0909

9116 E Sprague Ave
Suite 278
Spokane, WA 99206-5094

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of nail tissue20
Removal or shaving of skin growth24
Skin biopsy24

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1528050994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9116 E SPRAGUE AVE",
            "address_2": "#278",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-928-8181",
            "fax_number": "208-772-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N UNIVERSITY",
            "address_2": "#4",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-928-8181",
            "fax_number": "208-772-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABOL",
        "first_name": "JACQUELINE",
        "middle_name": "MENDOZA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2015-11-10",
        "deactivation_date": "2005-08-22",
        "reactivation_date": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000715",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ID",
            "license": "P218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116623",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.