Roner Rivera Mendoza, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4053-C Issued in AS

Practice address

96799 Turner Drive
Pago Pago, AS 96799-9994

Phone

(684) 633-1222

Fax

(684) 633-2893

NPI assigned

May 10, 2016

Last updated

May 10, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• American Samoa Medical Center

  • Internal Medicine Physician
  • Pago, AS
  • NPI 1043085681
  Medicare reassignment NPD

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1851747745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967999994",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96799 TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967999994",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "RONER",
        "middle_name": "RIVERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AS",
            "license": "4053-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manu'a Medical Center, Inc. (Manu'a Medical)
• Mary Lenati Mataia, MBBS
• Jemesa Nacaginimasei Matalau, MBBS
• Lumepa Matatia-Kuki, DDS
• Amelita Lourdes P Mejia, MD
• Miner Audiology, LLC
• Raymond Michael Miner, CCC-A
• Faasegia Moananu-Sala, TCT
• Enrique Fernandez Montes
• Bethel T. Muasau-Howard, MBBS

• Emergency Medicine Physician in Pago Pago, AS
• Providers in Pago Pago, AS by specialty
• Emergency Medicine Physician in American Samoa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.