Individual provider Active NPI

Nicole Renee Mendez, NP

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1629322599
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
729962 Issued in TX
Practice address
7777 Forest Lane
A-307
Dallas, TX 75230
Phone
(972) 566-4866
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 729962 TX Primary

Addresses

Primary practice location

7777 Forest Lane
A-307
Dallas, TX 75230

Mailing address

419 Monte Vista Drive
Dallas, TX 75223
Phone (281) 799-7663

Other names 1

  • Mrs. Nicole Renee Nelson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140315000082 TX Practitioner - Nurse Practitioner 7315178340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Heart Surgery Center, PLLCGroup PAC ID 6901081363, 22 clinicians

Practice addresses (Care Compare)

7777 Forest LN
Dallas, TX 75230-2571
Phone (972) 566-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Heart Surgery Center, PLLC CurrentSince May 23, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

7777 Forest Ln
#D308
Dallas, TX 75230

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

7777 Forest Ln
Ste A307
Dallas, TX 75230
Phone (972) 566-4866

4500 Medical Center Dr
McKinney, TX 75069
Phone (972) 547-8190

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Interoperability endpoints

  • Direct secure messaging: nicole.mendez@hca7.eclinicaldirectplus.com

Organizations & group practices 1

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.

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": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1629322599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 MONTE VISTA DRIVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75223",
            "telephone_number": "281-799-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LANE",
            "address_2": "A-307",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-566-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "729962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "NELSON",
            "middle_name": "RENEE",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.