Individual provider Active NPI

Juan Pablo Mendez, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Wichita, KS
National Provider Identifier
1659095958
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
558042 Issued in KS
Practice address
6505 E. Central, Suite 288
Wichita, KS 67206-1924
Phone
(316) 789-8444
Fax
(316) 789-8444
NPI assigned
Sep 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 147049 KS
Certified Registered Nurse Anesthetist 367500000X 222401 OK
Certified Registered Nurse Anesthetist 367500000X 558042 KS Primary

Addresses

Primary practice location

6505 E. Central, Suite 288
Wichita, KS 67206-1924

Mailing address

13716 E. Mainsgate St.
Wichita, KS 67228-8049
Phone (210) 528-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221201001916 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850769480 Reassigns benefits to 2 organizations
I20250320000720 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850769480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Anesthesia Services, LLCGroup PAC ID 0042587842, 21 clinicians
Portland Anesthesia Services LLCGroup PAC ID 8224512512, 21 clinicians

Practice addresses (Care Compare)

5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone (405) 604-6000

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147049KSMDRegistered Nurse
558042KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Nov 15, 2022 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Nov 15, 2022 Accepting new patients
Mid-Continent Anesthesiology Chartered CurrentSince Jan 27, 2023 Accepting new patients
Deaconess Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 31, 2025 Accepting new patients

Locations

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

1947 N Founders Cir
Wichita, KS 67206
Phone (316) 613-4640

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

Organizations & group practices 5

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 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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1659095958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13716 E. MAINSGATE ST.",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672288049",
            "telephone_number": "210-528-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 E. CENTRAL, SUITE 288",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061924",
            "telephone_number": "316-789-8444",
            "fax_number": "316-789-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-29",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "147049",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "222401",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "558042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.