Individual provider Active NPI

Jaime Mendoza, LOTR,CHT

  • Occupational Therapist
  • Lafayette, LA
National Provider Identifier
1881694487
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
Z12097 Issued in LA
Practice address
2727 Kaliste Saloom Rd
Suite 101
Lafayette, LA 70508-7151
Phone
(337) 981-4053
Fax
(337) 981-2448
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Z12097 LA Primary

Addresses

Primary practice location

2727 Kaliste Saloom Rd
Suite 101
Lafayette, LA 70508-7151

Mailing address

PO Box 52522
Lafayette, LA 70505-2522
Phone (337) 981-4053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050509001058 LA Practitioner - Occupational Therapist in Private Practice 5799725750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laborde Therapy Center LLCGroup PAC ID 2668469545, 13 clinicians

Practice addresses (Care Compare)

2727 Kaliste Saloom Rd
Suite 101
Lafayette, LA 70508-7164
Phone (337) 981-4053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Z12097LAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Laborde Therapy Center LLC Occupational Therapist CurrentSince Jan 1, 2004 Accepting new patients
Laborde Hand and Occupational Therapy Center Occupational Therapist PastSince Jan 1, 2004 Accepting new patients

Locations

3500 NE Evangeline Trwy
Ste A
Carencro, LA 70520
Phone (337) 981-4053

2443 Rice Capital Pkwy
Ste C
Crowley, LA 70526
Phone (337) 981-4053

2727 Kaliste Saloom Rd
Ste 101
Lafayette, LA 70508
Phone (337) 981-4053

1231 David Dr
Morgan City, LA 70380
Phone (985) 385-3222

106 Oceans Blvd
Youngsville, LA 70592
Phone (337) 451-2468

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1881694487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52522",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052522",
            "telephone_number": "337-981-4053",
            "fax_number": "337-981-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 KALISTE SALOOM RD",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087151",
            "telephone_number": "337-981-4053",
            "fax_number": "337-981-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JAIME",
        "name_prefix": "Mr.",
        "credential": "LOTR,CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "Z12097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.