Vicki R Mendelson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006408 Issued in MI

Practice address

22454 Chatsford Circuit St
Southfield, MI 48034-6240

Phone

(248) 464-2285

NPI assigned

Aug 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1699023085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22454 CHATSFORD CIRCUIT ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480346240",
            "telephone_number": "248-464-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22454 CHATSFORD CIRCUIT ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480346240",
            "telephone_number": "248-464-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELSON",
        "first_name": "VICKI",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006408",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mendelson Kornblum Southfield Physical Therapy PLLC
• Mendelson Orthopedics PC
• Mendelson Orthopedics PC
• Mendelson Orthopedics, PC
• Avery Harris Mendelson, M.D.
• Beatriz Mendez
• Kanwar Virender Mendiratta, M.D.
• Madhu Mendiratta, MD
• Surinder Mendiratta, MD
• Nayelie Mendoza

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.