Individual provider Active NPI

Fernando F Mendez, PA C

  • Physician Assistant
  • Leesburg, VA
National Provider Identifier
1891789426
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110840623 Issued in VA
Practice address
224-D Cornwall Street, NW, Suite 202
Leesburg, VA 20176-2700
Phone
(703) 443-8110
Fax
(703) 443-2714
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110840623 VA Primary

Addresses

Primary practice location

224-D Cornwall Street, NW, Suite 202
Leesburg, VA 20176-2700

Mailing address

224 D Cornwall Street NW
Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 2

IdentifierTypeStateIssuer
30016109960001MedicaidVA
1891789426MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050624001073 VA Practitioner - Physician Assistant 9234174665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

224 D Cornwall St NW
Leesburg, VA 20176-2700

Hospital & facility affiliations

  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110840623VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince May 1, 2005 Accepting new patients
Loudoun Medical Group, PC CurrentSince May 1, 2005 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

224D Cornwall St NW
Leesburg, VA 20176
Phone (571) 291-3458

44055 Riverside Pkwy
#20811302
Leesburg, VA 20176
Phone (703) 729-7652

224D Cornwall St NW
Ste 202
Leesburg, VA 20176
Phone (703) 443-8110

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

46165 Westlake Dr
Ste 100
Sterling, VA 20165
Phone (703) 433-1700

Interoperability endpoints

  • Direct secure messaging: fernando.mendez@lmg1.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1891789426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 D CORNWALL STREET NW",
            "address_2": "STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 202",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762700",
            "telephone_number": "703-443-8110",
            "fax_number": "703-443-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "FERNANDO",
        "middle_name": "F",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016109960001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891789426",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.