Individual provider Active NPI

Luis Terry Menendez, M.D.

  • Dermatology Physician
  • Tampa, FL
National Provider Identifier
1871536615
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
24434 Issued in FL
Practice address
3011 W Swann Ave
Tampa, FL 33609-4059
Phone
(813) 879-8436
Fax
(813) 878-2405
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 24434 FL Primary

Addresses

Primary practice location

3011 W Swann Ave
Tampa, FL 33609-4059

Mailing address

3011 W Swann Ave
Tampa, FL 33609-4059
Phone (813) 879-8436

Other identifiers 3

IdentifierTypeStateIssuer
3211253OtherFLAETNA
204969400MedicaidFL
406073185OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071008000071 FL Practitioner - Dermatology 2769577626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Miami, LM Miller School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3011 Swann Ave
Tampa, FL 33609-4059
Phone (813) 879-8436

Merit-based Incentive Payment System (MIPS)

Final score
79.17 of 100Reported as individual
Quality
58.33
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision36
Removal of skin lesions786
Skin biopsy181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24434FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luis T Menendez MD PA Dermatology CurrentSince Oct 17, 2007 Accepting new patients
Tampa General Hospital Current Accepting new patients

Locations

3011 W Swann Ave
Tampa, FL 33609
Phone (813) 879-8436

Interoperability endpoints

  • Direct secure messaging: lmenendez6343@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1871536615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 W SWANN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094059",
            "telephone_number": "813-879-8436",
            "fax_number": "813-878-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 W SWANN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094059",
            "telephone_number": "813-879-8436",
            "fax_number": "813-878-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "LUIS",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "24434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3211253",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204969400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "406073185",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.