Individual provider Active NPI

Daniel Mendoza, PT, DPT

  • Physical Therapist
  • Cedar Park, TX
National Provider Identifier
1629686738
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1331309 Issued in TX
Practice address
2519 S Lakeline Blvd Ste 100
Cedar Park, TX 78613-2964
Phone
(512) 331-6200
Fax
(512) 331-6384
NPI assigned
Jul 15, 2020
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1331309 TX Primary

Addresses

Primary practice location

2519 S Lakeline Blvd Ste 100
Cedar Park, TX 78613-2964

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811001316 TX Practitioner - Physical Therapist in Private Practice 5890110670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17220 N RM
620 Suite 110
Round Rock, TX 78681-3913
Phone (512) 527-6007

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tillman Physical Therapy & Sports Training Center, Inc CurrentSince Jun 1, 2020 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Mar 15, 2021 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Mar 15, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

2519 S Lakeline Blvd
Ste 100
Cedar Park, TX 78613
Phone (512) 331-6200

5004 Gattis School Rd
Ste 220
Hutto, TX 78634
Phone (512) 813-2087

1825 Crystal Falls Pkwy
Ste 150
Leander, TX 78641
Phone (512) 817-5001

2606 W Pecan St
Ste 102
Pflugerville, TX 78660
Phone (512) 527-6298

17220 N Rm 620 Rd
Ste 110
Round Rock, TX 78681
Phone (512) 527-6007

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1629686738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 S LAKELINE BLVD STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "512-331-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "DANIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1331309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.