Individual provider Active NPI

Kasia Nelene Mendoza, FNP

  • Family Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1689186413
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135687 Issued in TX
Practice address
35 E 31St St
San Angelo, TX 76903-2207
Phone
(325) 658-5339
Fax
(325) 659-8762
NPI assigned
Nov 2, 2017
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135687 TX Primary

Addresses

Primary practice location

35 E 31St St
San Angelo, TX 76903-2207

Mailing address

PO Box 1648
Fort Stockton, TX 79735-1648

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
I20180116002133 TX Practitioner - Nurse Practitioner 0345509550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Esperanza Clinic IncGroup PAC ID 7416942933, 13 clinicians

Practice addresses (Care Compare)

35 E 31St St
San Angelo, TX 76903-2207
Phone (325) 658-5339

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP135687TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Esperanza Clinic, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Pecos County Memorial Hospital Current Accepting new patients
La Esperanza Clinic, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Pecos County Memorial Hospital CurrentSince Nov 1, 2017 Accepting new patients
La Esperanza Clinic Inc Current Accepting new patients
Pecos County Memorial Hospital CurrentSince Nov 1, 2017 Accepting new patients

Locations

387 W Interstate 10
Fort Stockton, TX 79735
Phone (432) 336-2004

511 N Main St
Fort Stockton, TX 79735
Phone (432) 336-2291

34 Buick St
San Angelo, TX 76901
Phone (325) 658-5339

35 E 31st St
San Angelo, TX 76903
Phone (325) 658-5339

35 E 31st St
Ste 1
San Angelo, TX 76903

Interoperability endpoints

  • Direct secure messaging: kmendoza40307@shannonhealth.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1689186413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797351648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E 31ST ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769032207",
            "telephone_number": "325-658-5339",
            "fax_number": "325-659-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "KASIA",
        "middle_name": "NELENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.