Jorge G. Mendez,MD. LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

25MA08542000 Issued in NJ

Legal business name

JORGE G. MENDEZ,MD. LLC

Practice address

9 Crestfield Rd
Boonton, NJ 07005-9007

Phone

(908) 255-6200

Fax

(973) 794-4261

NPI assigned

Dec 8, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jorge G. Mendez, MDNPI 1356463988

Title

President

Phone

(908) 255-6200

Specialties & licenses 3

Addresses

Other names 1

• Ivy League Pain Management Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge G Mendez, MD

  • Pain Medicine (Anesthesiology) Physician
  • Boonton, NJ
  • NPI 1356463988
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1669870689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CRESTFIELD RD",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070059007",
            "telephone_number": "908-255-6200",
            "fax_number": "973-794-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CRESTFIELD RD",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070059007",
            "telephone_number": "908-255-6200",
            "fax_number": "973-794-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE G. MENDEZ,MD. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-255-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08542000",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA08542000",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy League Pain Management Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ivy League Pain Management Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pain Medicine (Anesthesiology) Physician in Boonton, NJ
• Providers in Boonton, NJ by specialty
• Pain Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.