NPIMap

Individual provider Active NPI

Ivan Mendoza, MD

  • Clinical Cardiac Electrophysiology Physician
  • Miami, FL
National Provider Identifier
1770790057
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME109272 Issued in FL
Practice address
3801 Biscayne Blvd Ste 230
Miami, FL 33137-9800
Phone
(786) 466-8490
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X ME109272 FL Primary

Addresses

Primary practice location

3801 Biscayne Blvd Ste 230
Miami, FL 33137-9800

Mailing address

1500 NW 12TH Ave Ste 810
Miami, FL 33136-1037
Phone (305) 585-6649

Other names 1

  • Dr. Ivan Mendoza Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140623000619 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8820212491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9380 SW 150TH St
Miami, FL 33176-7947
Phone (305) 256-5018

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME109272FLMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 31, 2014 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 31, 2014 Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

2801 NW 79th Ave
Ste 402
Doral, FL 33122
Phone (786) 466-1286

1801 NW 9th Ave
Ste 209
Miami, FL 33136
Phone (786) 466-8490

9380 SW 150th St
Miami, FL 33176
Phone (305) 256-5270

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

9380 SW 150th St
Ste 295
Miami, FL 33176
Phone (305) 256-5018

9380 SW 150th St
Ste 290
Miami, FL 33176
Phone (305) 251-3434

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1770790057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NW 12TH AVE STE 810",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361037",
            "telephone_number": "305-585-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BISCAYNE BLVD STE 230",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331379800",
            "telephone_number": "786-466-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME109272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVAN",
            "last_name": "MENDOZA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.