Individual provider Active NPI

Jose Mario Ugarriza Mendoza, MD

  • Pediatric Cardiology Physician
  • Fort Myers, FL
National Provider Identifier
1770052599
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME162837 Issued in FL
Practice address
16281 Bass Rd
Fort Myers, FL 33908-9687
Phone
(239) 343-7490
Fax
(239) 985-3515
NPI assigned
Nov 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X ME162837 FL Primary
Pediatrics Physician 208000000X ME162837 FL
Family Medicine Physician 207Q00000X P10584 NY

Addresses

Primary practice location

16281 Bass Rd
Fort Myers, FL 33908-9687

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-7490

Other practice location 1

3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (305) 666-6511

Other identifiers 1

IdentifierTypeStateIssuer
119864200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jugarrizamendoza717445@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P10584NYMDFamily Medicine Physician
ME162837FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Pediatric Services, PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1770052599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-7490",
            "fax_number": "239-985-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16281 BASS RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089687",
            "telephone_number": "239-343-7490",
            "fax_number": "239-985-3515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331553009",
            "country_code": "US",
            "telephone_number": "305-666-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UGARRIZA MENDOZA",
        "first_name": "JOSE",
        "middle_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME162837",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME162837",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "P10584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119864200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jugarrizamendoza717445@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.