Benjamin Mendoza, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149027148 Issued in IL

Practice address

6303 W 63Rd St Unit 3C
Chicago, IL 60638-7015

Phone

(773) 993-8389

NPI assigned

Jun 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mount Sinai Community Foundation

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  NPD

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

{
    "created_epoch": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1619539632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6303 W 63RD ST UNIT 3C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606387015",
            "telephone_number": "773-993-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6303 W 63RD ST UNIT 3C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606387015",
            "telephone_number": "773-993-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "BENJAMIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-29",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027148",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Michelle Mendoza Lopez, PA
• Nasya Mendoza-Elias
• Alexa Mendoza
• Amanda Victoria Mendoza
• Ana Maria Mendoza, APN
• Carolina Mendoza, MSN, RNC-OB, C-EFM
• Carrie D Mendoza, MD
• Daniel Mendoza, M.D.
• Diana Mendoza
• Joseph Albert Mendoza, MS, OTR/L

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.