Marie Jemie Mendoza, AG ACNP-BC, ACCNS-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP129028 Issued in TX

Practice address

1441 N Beckley Ave
Dallas, TX 75203-1201

Phone

(214) 947-8181

NPI assigned

Sep 16, 2015

Last updated

Jan 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Other names 1

• Ms. Marie Jemie Reyes Mendoza Other name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742
• Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dallas Pulmonary & Critical Care PA

  dba Exceed Medical P.A.

  • Critical Care Medicine (Internal Medicine) Physician
  • Dallas, TX
  • NPI 1235402728

  Acute Care

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Pointe Operating Company, LLC

  dba Baylor Scott & White Medical Center Lake Pointe

  • General Acute Care Hospital
  • Rowlett, TX
  • NPI 1205018439
  Care Compare affiliation
• Methodist Hospitals of Dallas

  dba Methodist Charlton Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1275592131
  Care Compare affiliation

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1720457054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "address_2": "PAVILION II, SUITE 929",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082363",
            "telephone_number": "214-941-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031201",
            "telephone_number": "214-947-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARIE",
        "middle_name": "JEMIE",
        "name_prefix": "Ms.",
        "credential": "AG ACNP-BC, ACCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP129028",
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "AP129028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "MENDOZA",
            "middle_name": "JEMIE REYES",
            "prefix": "MS.",
            "credential": "AG ACNP-BC, ACCNS-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Francisco Antonio Mendoza
• Isabel Mendoza
• Jazmin Mendoza
• Jose Angel Mendoza, LCDC
• Lilibeth Mendoza, RBT
• Mary Lyn Mendoza, CRNA
• Mildred Teves Mendoza, AGACNP-BC
• Paul Mendoza, O.D.
• Quinta Sheppard Mendoza, CRNA
• Roseann Estrada Mendoza

• Acute Care Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.