Individual provider Active NPI

Michael Catalino Mendoza, D.O.

  • Anesthesiology Physician
  • Parkersburg, WV
National Provider Identifier
1902894447
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
1508 Issued in WV
Practice address
800 Garfield Ave
Parkersburg, WV 26101-5340
Phone
(304) 424-2590
Fax
(304) 422-3924
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34007349 OH
Anesthesiology Physician 207L00000X 1508 WV Primary

Addresses

Primary practice location

800 Garfield Ave
Parkersburg, WV 26101-5340

Mailing address

601 Avery St Ste 501
Parkersburg, WV 26101-5192
Phone (304) 422-3904

Other identifiers 2

IdentifierTypeStateIssuer
0061281000MedicaidWV
0210275MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110120000965 WV Practitioner - Anesthesiology 3476529553 Reassigns benefits to 2 organizations
I20110124000810 OH Practitioner - Anesthesiology 3476529553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia School of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

800 Garfield Ave
Parkersburg, WV 26101-5376
Phone (304) 424-2111

Hospital & facility affiliations

  • Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1508WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
River Front Anesthesia Inc Anesthesiology CurrentSince Apr 1, 2012 Accepting new patients
Camden-Clark Physician Corporation CurrentSince Jan 20, 2025 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

608 Washington Blvd
Belpre, OH 45714
Phone (304) 422-3904

3211 Dudley Ave
Parkersburg, WV 26104
Phone (304) 422-3904

601 Avery St
Ste 501
Parkersburg, WV 26101
Phone (304) 422-3904

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

314 S Wells St
Sistersville, WV 26175
Phone (304) 652-2399

Organizations & group practices 4

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1902894447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 AVERY ST STE 501",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015192",
            "telephone_number": "304-422-3904",
            "fax_number": "304-422-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015340",
            "telephone_number": "304-424-2590",
            "fax_number": "304-422-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MICHAEL",
        "middle_name": "CATALINO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34007349",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "1508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061281000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210275",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.