Active NPI
Jacqueline Mendoza Babol, DPM
- Podiatrist
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO00000715
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1116623 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foot and Ankle Clinic of Spokane Inc | Current | Accepting new patients | |
| Foot and Ankle Clinic of Spokane Inc | Current | Accepting new patients | |
| Foot and Ankle Clinic of Spokane Inc | Past | Accepting new patients | |
| Foot and Ankle Clinic of Spokane Inc | Podiatrist | Past | 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
- 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.
-
- Foot & Ankle Surgery Podiatrist
- Spokane Valley, WA
- NPI 1497839823
ID, WA
-
- Durable Medical Equipment & Medical Supplies
- Hayden, ID
- NPI 1679938294
-
- Foot & Ankle Surgery Podiatrist
- Spokane Valley, WA
- NPI 1285626622
-
- Durable Medical Equipment & Medical Supplies
- Spokane Valley, WA
- NPI 1124109590
Podiatrist
-
- Ambulatory Surgical Clinic/Center
- Spokane Valley, WA
- NPI 1548252968
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
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 13 |
| Removal of nail tissue | 20 |
| Removal or shaving of skin growth | 24 |
| Skin biopsy | 24 |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.