Individual provider Active NPI

Gary Mendelow, M.D.

  • General Practice Physician
  • Boca Raton, FL
National Provider Identifier
1902825839
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME58449 Issued in FL
Practice address
22221 Morning Glory Ter
Boca Raton, FL 33433-4811
Phone
(561) 391-2818
Fax
(561) 391-0554
NPI assigned
Jul 19, 2006
Last updated
Aug 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME58449 FL Primary

Addresses

Primary practice location

22221 Morning Glory Ter
Boca Raton, FL 33433-4811

Mailing address

22221 Morning Glory Ter
Boca Raton, FL 33433-4811
Phone (561) 391-2818

Other names 1

  • Dr. Gary Mendelow Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME58449FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1902825839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22221 MORNING GLORY TER",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334811",
            "telephone_number": "561-391-2818",
            "fax_number": "561-391-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22221 MORNING GLORY TER",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334811",
            "telephone_number": "561-391-2818",
            "fax_number": "561-391-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELOW",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME58449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "MENDELOW",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.