NPIMap

Individual provider Active NPI

Evelyn Mendoza, M.D.

  • Specialist
  • Hemet, CA
National Provider Identifier
1558368605
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A48611 Issued in CA
Practice address
301 N San Jacinto St
Hemet, CA 92543-3113
Phone
(951) 766-6460
Fax
(951) 766-6459
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A48611 CA Primary

Addresses

Primary practice location

301 N San Jacinto St
Hemet, CA 92543-3113

Mailing address

23278 Kent CT
Murrieta, CA 92562-5086
Phone (951) 461-6653

Other identifiers 11

IdentifierTypeStateIssuer
05D1062719OtherCACLIA NUMBER
5945420003OtherCAMEDICARE PART D DME
5945420004OtherCAMEDICARE PART D DME
1225222029OtherCAMEDICARE PART B DME
00A486110MedicaidCA
1457545840OtherCAMEDICARE PART B DME
1558555938OtherCAMEDICARE PART B DME
330643850OtherCATAX INDENTIFICATION NUMBE
5945420001OtherCAMEDICARE PART D DME
1962696344OtherCAMEDICARE PART B DME
5945420002OtherCAMEDICARE PART D DME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080715000849 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7416020045

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

301 N San Jacinto St
Hemet, CA 92543-3119

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48611CAMDMarriage & Family Therapist
A48611CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Health Care District Past Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Menifee Valley Medical Center Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
Hemet Valley Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: emendoza182036@direct.llu.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1558368605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23278 KENT CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625086",
            "telephone_number": "951-461-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N SAN JACINTO ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433113",
            "telephone_number": "951-766-6460",
            "fax_number": "951-766-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A48611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "05D1062719",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART D DME",
            "identifier": "5945420003",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART D DME",
            "identifier": "5945420004",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B DME",
            "identifier": "1225222029",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A486110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B DME",
            "identifier": "1457545840",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B DME",
            "identifier": "1558555938",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX INDENTIFICATION NUMBE",
            "identifier": "330643850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART D DME",
            "identifier": "5945420001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B DME",
            "identifier": "1962696344",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART D DME",
            "identifier": "5945420002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.