Active NPI
Michael Mendoza, RD
- Registered Dietitian
- Las Cruces, NM
National Provider Identifier
1801377148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86030921
- Practice address
- 2450 S Telshor Blvd
Las Cruces, NM 88011-5141 - Phone
- (755) 228-6415
- NPI assigned
- Aug 24, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86030921 | IL | Primary |
Addresses
Primary practice location
2450 S Telshor Blvd
Las Cruces, NM 88011-5141
Mailing address
2942 Johnson St
Las Cruces, NM 88005-1288
Phone (575) 312-1039
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86030921 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1801377148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2942 JOHNSON ST",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880051288",
"telephone_number": "575-312-1039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 S TELSHOR BLVD",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880115141",
"telephone_number": "755-228-6415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "MICHAEL",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-24",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "86030921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.