Charles Vaccaro Menendez Jr., M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

13597 Issued in MS

Practice address

3109 Bienville Blvd
Ocean Springs, MS 39564-4361

Phone

(228) 762-1353

NPI assigned

Jul 3, 2006

Last updated

Mar 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmenendez@direct.mhg.com

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.

• SMB Radiology P a

  • Diagnostic Radiology Physician
  • Pascagoula, MS
  • NPI 1609877356
  Medicare reassignment NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1629008974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2710",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704592710",
            "telephone_number": "228-762-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644361",
            "telephone_number": "228-762-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 Ocean Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Ocean Springs",
            "state": "MS",
            "postal_code": "39564",
            "country_code": "US",
            "telephone_number": "228-875-0171",
            "fax_number": "228-875-0172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "CHARLES",
        "middle_name": "VACCARO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "13597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117198",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth W. McPhearson, PHD
• Medical Care Center, PLLC
• Medical Genetic Consultants Inc
• Memorial Hospital at Gulfport
• Memorial Hospital at Gulfport (Memorial Surgery Center Ocean Springs)
• Merikay Mitchell, LLC
• Julie Messenger, FNP
• Maegan Ann Miller, CPNP
• Sara Montague Miller, M.S.
• Tanyanisha Callahan Mills, NP

• Diagnostic Radiology Physician in Ocean Springs, MS
• Providers in Ocean Springs, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.