Individual provider Active NPI

Pedro Alberto Mendoza, AGACNP

  • Nurse Practitioner
  • Cody, WY
National Provider Identifier
1861769598
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP120223 Issued in TX
Practice address
707 Sheridan Ave
Cody, WY 82414-3409
Phone
(307) 527-7501
NPI assigned
Nov 23, 2011
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP120223 TX Primary
Acute Care Nurse Practitioner 363LA2100X 222969 CT
Acute Care Nurse Practitioner 363LA2100X 95023815 CA
Registered Nurse 163W00000X 705297 TX

Addresses

Primary practice location

707 Sheridan Ave
Cody, WY 82414-3409

Mailing address

8608 Spindletop Dr
Fort Worth, TX 76120-2001
Phone (915) 274-2868

Other practice location 1

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Other practice location 2

20 York St
New Haven, CT 06510-3220
Phone (915) 274-2868

Other identifiers 4

IdentifierTypeStateIssuer
222969OtherCTNURSE PRACTITIONER LICENSE
705297OtherTXRN LICENSE
95023815OtherCAACNP
AP120223OtherTXNURSE PRACTITIONER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA, CT, WY4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20120912000169 TX Practitioner - Nurse Practitioner 2961650205 Reassigns benefits to 6 organizations
I20240823001248 CA Practitioner - Nurse Practitioner 2961650205 Reassigns benefits to 4 organizations
I20240923003838 CT Practitioner - Nurse Practitioner 2961650205 Reassigns benefits to 1 organization
I20250227003587 WY Practitioner - Nurse Practitioner 2961650205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Park Hospital DistrictGroup PAC ID 7315855624, 85 clinicians
Cogent Healthcare of Texas PAGroup PAC ID 8628076924, 113 clinicians

Practice addresses (Care Compare)

707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 527-7501

8200 Walnut Hill LN
TX HLTH Presbyterian Dallas
Dallas, TX 75231-4402
Phone (214) 345-6789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.25 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.16
Improvement activities
40
Cost
76.01

Merit-based Incentive Payment System (MIPS)

Final score
98.98 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95023815CAMDAcute Care Nurse Practitioner
222969CTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Nurse Practitioner CurrentSince Oct 1, 2018 Accepting new patients
Usacs Critical Care Medicine Services of Texas, PLLC CurrentSince Jun 1, 2021 Accepting new patients
Northeast Medical Group, Inc. Nurse Practitioner CurrentSince Sep 9, 2024 Accepting new patients
Usacs Observation Medicine Services of Texas PLLC CurrentSince Jun 1, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 9, 2024 Accepting new patients
University of California San Francisco CurrentSince Aug 9, 2024 Accepting new patients
Cody Regional Health EMS CurrentSince Jan 9, 2025 Accepting new patients
West Park Hospital District CurrentSince Jan 9, 2025 Accepting new patients
UCSF Medical Group Business Services Nurse Practitioner CurrentSince Aug 9, 2024 Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince Jun 15, 2018 Accepting new patients
University Anesthesia Medical Group CurrentSince Aug 9, 2024 Accepting new patients
West Park Hospital District Current Accepting new patients
University of California San Francisco CurrentSince Aug 9, 2024 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Jun 1, 2021 Accepting new patients
University of California San Francisco Current Accepting new patients
West Park Hospital District CurrentSince Jan 9, 2025 Accepting new patients
Inpatient Specialists of California, PC CurrentSince Aug 1, 2024 Accepting new patients
Cogent Healthcare of Texas, PA Nurse Practitioner CurrentSince Jul 15, 2024 Accepting new patients
Running Wild Sea, LLC Past Accepting new patients
Central River Healthcare Group, PLLC Past Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA PastSince Dec 1, 2023 Accepting new patients

Locations (25 of 26)

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

20 York St
North Haven, CT 06510
Phone (203) 688-2433

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903

Interoperability endpoints

  • Direct secure messaging: pmendoza348815@ahs.direct-ci.com
  • Direct secure messaging: pmendoza745071@hisp.ehr.sutterhealth.org

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1861769598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8608 SPINDLETOP DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761202001",
            "telephone_number": "915-274-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-527-7501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Parnassus Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432204",
            "country_code": "US",
            "telephone_number": "415-476-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "915-274-2868",
            "fax_number": "475-246-9094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "PEDRO",
        "middle_name": "ALBERTO",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-23",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP120223",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "222969",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95023815",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "705297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "222969",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "705297",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACNP",
            "identifier": "95023815",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "AP120223",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.