Individual provider Active NPI

Ivan Mendez-Escobar, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Washington, DC
National Provider Identifier
1548580822
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
110 Irving St NW
Department of Pulmonary Disease / Critical Care Medicin
Washington, DC 20010-3017
Phone
(202) 877-7856
Fax
(202) 877-6130
NPI assigned
Jun 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

110 Irving St NW
Department of Pulmonary Disease / Critical Care Medicin
Washington, DC 20010-3017

Mailing address

110 Irving St NW
Department of Pulmonary Disease / Critical Care Medicin
Washington, DC 20010-3017
Phone (202) 877-7856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130925000874 WA Practitioner - Internal Medicine 0840435806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince Oct 1, 2018 Accepting new patients

Locations

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1548580822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "address_2": "DEPARTMENT OF PULMONARY DISEASE / CRITICAL CARE MEDICIN",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-7856",
            "fax_number": "202-877-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "address_2": "DEPARTMENT OF PULMONARY DISEASE / CRITICAL CARE MEDICIN",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-7856",
            "fax_number": "202-877-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ-ESCOBAR",
        "first_name": "IVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-09",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.