Manuel A Mendoza, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

38187 Issued in WI

Practice address

1405 Mill St
New London, WI 54961-2155

Phone

(920) 531-2000

Fax

(920) 531-2030

NPI assigned

Jan 13, 2006

Last updated

Nov 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI, VI, MP3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency Medicine

Education

University of Iowa, RJ & L Carver College of Medicine, 1994

Medicare assignment

May accept Medicare assignment

Group practices

VI Government Hospital and Health Facilities CorpGroup PAC ID 6204722879, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107
• Roy Lester Schneider Hospital,the Hospital, St Thomas, VI, CCN 480001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: mmendoza299865@direct.thedacare.org
• Direct secure messaging: mmendoza854742@direct.froedtert.com

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.

• VI Government Hospital and Health Facilities Corp

  dba Schneider Regional Medical Center

  • General Acute Care Hospital
  • St Thomas, VI
  • NPI 1487699047
  Medicare reassignment Care Compare group NPD
• Beaver Dam Community Hospitals Inc

  dba Marshfield Medical Center - Beaver Dam Professional Services

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba MMC - Park Falls Outreach Services

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba Marshfield Medical Center - Park Falls

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  Medicare reassignment NPD
• Froedtert Manitowoc Medical Group, LLC

  dba Froedtert Northeast Medical Group

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake Professional Services

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434

  Emergency Medicine

  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Ladysmith

  • Critical Access Hospital
  • Ladysmith, WI
  • NPI 1952890873
  Medicare reassignment NPD
• Memorial Hospital Inc

  dba Marshfield Medical Center - Neillsville

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Sauk Prairie Healthcare Inc

  • General Acute Care Hospital
  • Prairie Du Sac, WI
  • NPI 1861466153
  Medicare reassignment NPD

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

• Holy Family Memorial Inc

  dba Froedtert Holy Family Memorial Hospital

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation
• VI Government Hospital and Health Facilities Corp

  dba Schneider Regional Medical Center

  • General Acute Care Hospital
  • St Thomas, VI
  • NPI 1487699047
  Care Compare affiliation

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1740269158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-531-2000",
            "fax_number": "920-531-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 14th St",
            "address_purpose": "LOCATION",
            "city": "Baraboo",
            "state": "WI",
            "postal_code": "539131539",
            "country_code": "US",
            "telephone_number": "608-356-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MANUEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "38187",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "387187-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32248400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEANCARE PROV #",
            "identifier": "70",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV #",
            "identifier": "930117017",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYS PLUS PROV #",
            "identifier": "1009390",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in New London, WI
• Providers in New London, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.