Individual provider Active NPI

Karla Josmara Mendez, AA

  • Prevention Professional
  • Mentor, OH
National Provider Identifier
1699293126
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
License
RA.4576 Issued in OH
Practice address
8445 Munson Rd
Mentor, OH 44060-2410
Phone
(440) 205-1700
Fax
(440) 205-2417
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Prevention Professional 405300000X RA.4576 OH Primary

Addresses

Primary practice location

8445 Munson Rd
Mentor, OH 44060-2410

Mailing address

8445 Munson Rd
Mentor, OH 44060-2410
Phone (440) 205-1700

Other practice location 1

38876 Mentor Ave
Willoughby, OH 44094-7931
Phone (440) 578-8200

Other identifiers 1

IdentifierTypeStateIssuer
2844093MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327000332 OH Practitioner - Clinical Social Worker 8921521287 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
RA.4576OHMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince Jan 27, 2025 Accepting new patients
Signature Health, Inc. Current Accepting new patients
Signature Health Inc CurrentSince Jan 27, 2025 Accepting new patients

Locations

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38882 Mentor Ave
Willoughby, OH 44094

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1699293126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8445 MUNSON RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440602410",
            "telephone_number": "440-205-1700",
            "fax_number": "440-205-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 MUNSON RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440602410",
            "telephone_number": "440-205-1700",
            "fax_number": "440-205-2417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38876 Mentor Ave",
            "address_purpose": "LOCATION",
            "city": "Willoughby",
            "state": "OH",
            "postal_code": "440947931",
            "country_code": "US",
            "telephone_number": "440-578-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "KARLA",
        "middle_name": "JOSMARA",
        "credential": "AA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OH",
            "license": "RA.4576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2844093",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.