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
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E10000140 DE Primary

Addresses

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

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

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 PAGroup PAC ID 6103800057, 97 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E10000140DEMDPodiatrist

Practice roles

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

Locations

12100 Black Swan Dr
Ste 201
Lewes, DE 19958

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

4745 Ogletown Stanton Rd
Ste 238
Newark, DE 19713

Interoperability endpoints

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

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

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": "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.