NPIMap

Individual provider Active NPI

Widalys Adames-Mendez, M.D.

  • Family Medicine Physician
  • Marietta, OH
National Provider Identifier
1922253269
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.121004 Issued in OH
Practice address
802 Wayne St Ste 200
Marietta, OH 45750
Phone
(740) 374-8272
Fax
(740) 374-0509
NPI assigned
Dec 1, 2008
Last updated
Jul 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.121004 OH Primary

Addresses

Primary practice location

802 Wayne St Ste 200
Marietta, OH 45750

Mailing address

PO Box 449
Marietta, OH 45750-0449
Phone (740) 374-4500

Other practice location 1

400 Matthew St Ste 211
Marietta, OH 45750-1656
Phone (740) 434-0720

Other identifiers 2

IdentifierTypeStateIssuer
3810026450MedicaidWV
0088220MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000280 NJ Practitioner - Family Practice 8123297959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ponce School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

2500 English Creek Ave
Egg Harbor Township, NJ 08234-5549

459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225
Phone (609) 340-7815

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince Dec 16, 2019 Accepting new patients
Atlanticare Physician Group PA Family Medicine Current Accepting new patients
Atlanticare Physician Group CurrentSince Dec 16, 2019 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients
Atlanticare Physician Group Past Accepting new patients

Locations

6550 Delilah Rd
Ste 301
Egg Hbr Twp, NJ 08234
Phone (609) 573-1251

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1922253269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 WAYNE ST STE 200",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-374-8272",
            "fax_number": "740-374-0509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Matthew St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501656",
            "country_code": "US",
            "telephone_number": "740-434-0720",
            "fax_number": "740-568-4189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMES-MENDEZ",
        "first_name": "WIDALYS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.121004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026450",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088220",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.