Bertha P Mendieta, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1014596 Issued in TX

Practice address

2701 Hospital Dr
Victoria, TX 77901-5749

Phone

(361) 575-6396

Fax

(361) 578-5203

NPI assigned

Oct 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1528600384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015749",
            "telephone_number": "361-575-6396",
            "fax_number": "361-578-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015749",
            "telephone_number": "361-575-6396",
            "fax_number": "361-578-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIETA",
        "first_name": "BERTHA",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1014596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Na",
            "affiliation": "N",
            "address_1": "Citizens Victoria Surgical Associates",
            "address_2": "2705 Hospital Drive Suite 400, Building B",
            "city": "Victoria",
            "state": "TX",
            "country_code": "US",
            "postal_code": "77904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meals on Wheels South Texas
• Med C Clinico
• Matias Relos Medina, MD
• Gregory G Meister, PHARM.D.
• Sergio Mejia, MD
• Melissa Ann Mendoza
• Mercer Emergency Physicians Victoria PLLC
• Mandy M Mercer, PTA
• Elaine Mary Messarra, M.S. L.P.C.
• Metx, LLC

• Physician Assistant in Victoria, TX
• Providers in Victoria, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.