Simon Mendoza Moreno, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60672657 Issued in WA

Practice address

6240 Tacoma Mall Blvd Ste 101
Tacoma, WA 98409-6819

Phone

(253) 271-9720

Fax

(253) 212-3372

NPI assigned

Feb 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Merit-based Incentive Payment System (MIPS)

Final score

50.5 of 100Reported as group

Quality

44.61

Promoting interoperability

0

Improvement activities

40

Cost

50.57

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Dispatchhealth Advanced Care - Washington PC

  • Hospitalist Physician
  • Denver, CO
  • NPI 1093324659
  NPD

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1902298987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE",
            "address_2": "STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000",
            "fax_number": "509-664-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 TACOMA MALL BLVD STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096819",
            "telephone_number": "253-271-9720",
            "fax_number": "253-212-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA MORENO",
        "first_name": "SIMON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-27",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60672657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherryl Anne Menapace, NP
• Kyle Menday, RN
• Sierra Mendez
• Ulysses Mendez, LMT
• Jasmine Mendiola, MASSAGE THERAPIST
• Kindra Michelle Mendoza, LPN
• Maria Theresa Fernandez Mendoza, P.T.
• Zea Mendoza
• Elizabeth Mendus
• Andrew Meng, DO

• Medical Physician Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.
• 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.