Mary Jean Mendizabal, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

85002898 Issued in IL

Practice address

1 N Broadway St
Des Plaines, IL 60016-2335

Phone

(847) 298-3150

Fax

(847) 298-5235

NPI assigned

Oct 23, 2006

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmendizabal5805@direct.achn.net

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.

• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Des Plaines, IL
  • NPI 1982783692
  Medicare reassignment Care Compare group NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1699701383
  NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1780754523
  NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1043398217
  NPD (past)
• Polina Reyngold, LTD

  • Professional Counselor
  • Evanston, IL
  • NPI 1649644071
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  dba Advocate Lutheran General Hospital

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902989908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 W BEACH AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512592",
            "telephone_number": "347-907-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N BROADWAY ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162335",
            "telephone_number": "847-298-3150",
            "fax_number": "847-298-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIZABAL",
        "first_name": "MARY JEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85002898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell B Meghpara, M.D.
• Snehal Mehta, P.T.
• Jessica Ann Mejia
• Amanda Melesio
• Men's Clinic, PLLC
• Laura Mendoza, LAC, DIPL. AC
• Mark Anthony Mendoza, PTA
• Mylinh Hau Mendoza, SLP
• Rosa Maria Mendoza, NP
• Vanessa Mendoza, ATC

• Physician Assistant in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.