Individual provider Active NPI

Robert Eugene Mendonsa, M.D.

  • Orthopaedic Surgery Physician
  • Lewisville, TX
National Provider Identifier
1760430508
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
J4348 Issued in TX
Practice address
500 W Main St
#200
Lewisville, TX 75057-3639
Phone
(972) 420-1776
Fax
(972) 221-8685
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X J4348 TX Primary

Addresses

Primary practice location

500 W Main St
#200
Lewisville, TX 75057-3639

Mailing address

PO Box 977
Lewisville, TX 75067-0977
Phone (972) 420-1776

Other identifiers 3

IdentifierTypeStateIssuer
030782901MedicaidTX
200031204OtherTXRAILROAD MEDICARE
8BF128OtherTXBLUECROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1760430508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 977",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750670977",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "#200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573639",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDONSA",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "J4348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030782901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200031204",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "8BF128",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.