Individual provider Active NPI

Katherine Massiel Hernandez Mendez, MD

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1790480465
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME83275 Issued in FL
Practice address
5851 Saint Augustine Rd
Jacksonville, FL 32207-8015
Phone
(904) 396-3964
Fax
(904) 396-0128
NPI assigned
Apr 3, 2023
Reactivated
Dec 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME83275 FL Primary

Addresses

Primary practice location

5851 Saint Augustine Rd
Jacksonville, FL 32207-8015

Mailing address

1300 Hendricks Ave
Jacksonville, FL 32207-8680
Phone (856) 807-7442

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P24-00817NJMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1790480465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HENDRICKS AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078680",
            "telephone_number": "856-807-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078015",
            "telephone_number": "904-396-3964",
            "fax_number": "904-396-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ MENDEZ",
        "first_name": "KATHERINE",
        "middle_name": "MASSIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "deactivation_date": "2023-11-06",
        "reactivation_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME83275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.