Individual provider Active NPI

Gloria J Mendoza

  • Specialist
  • Forest Hills, NY
National Provider Identifier
1659629475
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
7000 Austin St
Forest Hills, NY 11375-1022
Phone
(631) 619-7016
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 16897 NY
Specialist 174400000X Primary

Addresses

Primary practice location

7000 Austin St
Forest Hills, NY 11375-1022

Mailing address

7000 Austin St
Forest Hills, NY 11375-1022
Phone (631) 619-7016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16897NYMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1659629475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "631-619-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "631-619-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "GLORIA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "16897",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.