Loreta A Mendoza, M.D

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

34045 Issued in MO

Practice address

1034 S Brentwood Blvd Ste 1250
Forest Park Medical Clinic
St,Louis, MO 63117-1263

Phone

(314) 367-6600

Fax

(314) 367-5982

NPI assigned

Nov 12, 2010

Last updated

Nov 12, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Loreta Galutera Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1881995462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11845 CRESTA VERDE DR",
            "address_2": "APTC",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464746",
            "telephone_number": "314-997-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD STE 1250",
            "address_2": "FOREST PARK MEDICAL CLINIC",
            "city": "ST,LOUIS",
            "state": "MO",
            "postal_code": "631171263",
            "telephone_number": "314-367-6600",
            "fax_number": "314-367-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "LORETA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MO",
            "license": "34045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORETA",
            "last_name": "GALUTERA",
            "prefix": "MRS.",
            "credential": "M,D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jazmyne Courtnye Jennings, PLPC
• Samuel Mugwe Kimari, OTR/L
• Laura Laney, CNM
• Habibu Hussein Luziga, M.D.
• Swetha Manoj, M.D
• Zaid Ahmed Mohammed
• William J Norbury, RPH, MBA
• Nugget's Healthcare Services, LLC
• Gurpreet S. Padda, MD
• Mashal Aziz Rana, MBBS

• Health Service Clinic/Center in St.Louis, MO
• Providers in St.Louis, MO by specialty
• Health Service Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.