Individual provider Active NPI

Astryd Menendez, MD

  • Pediatric Pulmonology Physician
  • Springdale, AR
National Provider Identifier
1790713352
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
E0471 Issued in AR
Practice address
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone
(479) 725-6880
Fax
(479) 725-6582
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X E0471 AR Primary

Addresses

Primary practice location

2601 Gene George Blvd
Springdale, AR 72762-0845

Mailing address

PO Box 8069
Fayetteville, AR 72701
Phone (479) 756-2556

Other identifiers 3

IdentifierTypeStateIssuer
127734001MedicaidAR
0211003660OtherQUALCHOICE
5J800OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000382 AR Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 9638279797 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E0471ARMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Children'S Hospital CurrentSince Jan 13, 2008 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jan 13, 2008 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 1995 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 1995 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Childrens Northwest, Inc. Past Accepting new patients

Locations

800 Marshall St
Ste 653
Little Rock, AR 72202
Phone (501) 364-4020

1 Childrens Way
Ste 653
Little Rock, AR 72202

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800

Interoperability endpoints

  • FHIR API: https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1790713352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8069",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72701",
            "telephone_number": "479-756-2556",
            "fax_number": "479-756-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6880",
            "fax_number": "479-725-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "ASTRYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "AR",
            "license": "E0471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127734001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "0211003660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5J800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.