Individual provider Active NPI

Cecelia Mendiola, MD

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1871959866
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0091285 Issued in MD
Practice address
6350 Stevens Forest Rd Ste 103
Columbia, MD 21046-3255
Phone
(443) 367-4740
NPI assigned
Jan 7, 2016
Last updated
Jul 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0091285 MD Primary

Addresses

Primary practice location

6350 Stevens Forest Rd Ste 103
Columbia, MD 21046-3255

Mailing address

6350 Stevens Forest Rd Ste 103
Columbia, MD 21046-3255
Phone (443) 367-4740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210802000803 MD Practitioner - Pediatric Medicine 6103174453 Reassigns benefits to 1 organization
I20210802001094 DC Practitioner - Pediatric Medicine 6103174453 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0091285MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

600 N Wolfe St
Baltimore, MD 21287

6350 Stevens Forest Rd
Ste 103
Columbia, MD 21046
Phone (443) 259-3770

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: cmendiola187319@direct.hopkinsmedicine.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1871959866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 STEVENS FOREST RD STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463255",
            "telephone_number": "443-367-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 STEVENS FOREST RD STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463255",
            "telephone_number": "443-367-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "CECELIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0091285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.