Individual provider Active NPI

Katie A Menendez, APRN

  • Nurse Practitioner
  • Highland, IL
National Provider Identifier
1548980220
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209026181 Issued in IL
Practice address
12860 Troxler Ave
Highland, IL 62249-2898
Phone
(618) 651-2810
Fax
(618) 651-0077
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041464694 IL
Nurse Practitioner 363L00000X 209026181 IL Primary

Addresses

Primary practice location

12860 Troxler Ave
Highland, IL 62249-2898

Mailing address

12860 Troxler Ave
Highland, IL 62249-2898
Phone (618) 651-2810

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmenendez247654@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230117001258 IL Practitioner - Nurse Practitioner 2860863578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians
St Josephs Hospital of the Hospital Sisters of the Third Order of St FGroup PAC ID 4183617517, shared by 2 NPIs, 26 clinicians

Practice addresses (Care Compare)

12860 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2810

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041464694ILMDRegistered Nurse
209026181ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Nov 1, 2022 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients
SJL Health Systems Inc CurrentSince Nov 1, 2022 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

12860 Troxler Ave
Highland, IL 62249
Phone (618) 235-3687

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

Organizations & group practices 4

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 7

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1548980220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898",
            "telephone_number": "618-651-2810",
            "fax_number": "618-651-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898",
            "telephone_number": "618-651-2810",
            "fax_number": "618-651-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "KATIE",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041464694",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209026181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmenendez247654@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "12860 Troxler Ave",
            "city": "Highland",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622492898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

Verify at the official NPI Registry.