Individual provider Active NPI

Mark Mendoza

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1932683778
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2393 Issued in HI
Practice address
888 S King St
Honolulu, HI 96813-3097
Phone
(808) 522-4344
NPI assigned
Sep 18, 2018
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2393 HI Primary

Addresses

Primary practice location

888 S King St
Honolulu, HI 96813-3097

Mailing address

95-1047 Hakala St
Mililani, HI 96789-4256
Phone (808) 382-4364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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

Enrollment IDStateProvider typePAC IDDetails
I20190116002719 HI Practitioner - Nurse Practitioner 7416293147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2393HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Dec 2, 2018 Accepting new patients
Straub Clinic & Hospital CurrentSince Dec 2, 2018 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

95-390 Kuahelani Ave
Ste J1
Mililani, HI 96789
Phone (808) 909-3252

Organizations & group practices 3

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 1

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1932683778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1047 HAKALA ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967894256",
            "telephone_number": "808-382-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133097",
            "telephone_number": "808-522-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "2393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.