Individual provider Active NPI

Mark M Menendez, D.P.M.

  • Podiatrist
  • Lewes, DE
National Provider Identifier
1619903556
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E10000140 Issued in DE
Practice address
12100 Black Swan Dr Ste 201
Lewes, DE 19958-4991
Phone
(302) 644-3311
Fax
(302) 644-3300
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First State Orthopaedics PA 97 clinicians

Practice addresses (Care Compare)

12100 Black Swan Dr
Suite 201
Lewes, DE 19958-4988
Phone (302) 644-3311

Hospital & facility affiliations

  • Beebe Hospital Home Health Home health agency, Millsboro, DE, CCN 087023
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007
  • Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009
  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
96
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue396
Removal of skin lesions1-10
Removal of nail tissue1046
Removal or shaving of skin growth424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000462 DE Practitioner - Podiatry 4880676543 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E10000140DEMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
First State Orthopaedics PA CurrentSince Sep 1, 2022 Accepting new patients
First State Orthopaedics PA Podiatrist CurrentSince Sep 1, 2022 Accepting new patients
First State Orthopaedics, PA Podiatrist Past Accepting new patients
First State Orthopaedics, PA Past Accepting new patients

Locations

12100 Black Swan Dr
Ste 201
Lewes, DE 19958

4745 Ogletown Stanton Rd
Ste 238
Newark, DE 19713

211 Executive Dr
Ste 11
Newark, DE 19702
Phone (302) 793-1800

Interoperability endpoints

  • Direct secure messaging: mark.menendezdpm.p2@direct.fsoortho.nextgenshare.com
  • Direct secure messaging: mmenendez23094@beebehealth.direct-ci.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E10000140 DE Primary

Addresses

NPPES NPI Registry

Primary practice location

12100 Black Swan Dr Ste 201
Lewes, DE 19958-4991

Mailing address

211 Executive Dr Ste 11
Newark, DE 19702-3358
Phone (302) 731-2888

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
1000017150MedicaidDE
0001026317MedicaidDE
1184681488OtherCOMMERCIAL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 27, 2022.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1619903556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EXECUTIVE DR STE 11",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023358",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 BLACK SWAN DR STE 201",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584991",
            "telephone_number": "302-644-3311",
            "fax_number": "302-644-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "MARK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DE",
            "license": "E10000140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000017150",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001026317",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1184681488",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.