Reynaldo Mendibles Jr.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12291H Issued in AZ

Practice address

7475 E Rio Vista Cir
Tucson, AZ 85715-3547

Phone

(520) 304-1502

NPI assigned

Oct 3, 2022

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Illuminated Hearts LLC

  • Assisted Living Facility
  • Tucson, AZ
  • NPI 1902521602
  NPD Authorized official

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1760106611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 E RIO VISTA CIR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153547",
            "telephone_number": "520-304-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7475 E RIO VISTA CIR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153547",
            "telephone_number": "520-304-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIBLES",
        "first_name": "REYNALDO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "AZ",
            "license": "AL12291H",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL12291H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Brian Mendez, D.C.
• Jane S Mendez, NNP
• Leighton Mendez
• Marlo R Mendez, LPC
• Melissa Mendez, PT, DPT
• Hannah Mendivil
• Juan Jabbar Mendivil, PHARMD
• Lisa Marie Mendivil, CNP
• Ana Patricia Mendoza Covarrubias
• Mendoza Medical LLC

• Assisted Living Facility in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.