Michael Mendoza, CNS

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

4560 Crain Hwy Ste 11
White Plains, MD 20695-3084

Phone

(240) 210-9725

NPI assigned

Jul 31, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

Practice roles

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.

• Core Value Corporation

  • Registered Dietitian
  • White Plains, MD
  • NPI 1265961247
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1730918293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 CRAIN HWY STE 11",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 CRAIN HWY STE 11",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953084",
            "telephone_number": "240-210-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MICHAEL",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medstar Medical Group II LLC
• Medstar Medical Group II LLC
• Medstar Southern Maryland Physicians, LLC
• Mega Counseling Services, LLC
• Gloria Mehrtens
• Susana M Merida, DDS
• Kenneth Merritt
• Mid-Atlantic of Waldorf,LLC
• Sarah Fairfax Miles, LCPC
• Minuteclinic LLC

• Nutritionist in White Plains, MD
• Providers in White Plains, MD by specialty
• Nutritionist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.