Monica Jazmine Mendoza

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61302924 Issued in WA

Practice address

380 Chase Ave
Walla Walla, WA 99362-2924

Phone

(509) 897-5836

Fax

(509) 897-5743

NPI assigned

Apr 21, 2022

Last updated

Sep 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 WA

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmendoza1109659@wm.providencedirect.org
• Direct secure messaging: mmendoza37762@yvfwc.direct-ci.com

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.

• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738
  Medicare reassignment Care Compare group
• Yakima Valley Farm Workers Clinic

  dba Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Yakima, WA
  • NPI 1295788602
  Medicare reassignment
• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington Neurosurgery

  • Neurological Surgery Physician
  • Walla Walla, WA
  • NPI 1760636690
  NPD
• Yakima Valley Farm Workers Clinic

  dba Unify Community Health Northeast

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1932400546
  NPD
• Yakima Valley Farm Workers Clinic

  dba Community Health Center of Clatskanie

  • Federally Qualified Health Center (FQHC)
  • Clatskanie, OR
  • NPI 1578000345
  NPD
• Providence Health & Services - Washington

  dba Providence St Mary Medical Center

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)

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

• Providence Health & Services - Washington

  dba Providence St Mary Medical Center

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1962146498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "509-897-5836",
            "fax_number": "509-897-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "509-897-5836",
            "fax_number": "509-897-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MONICA",
        "middle_name": "JAZMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61302924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena C Mejia, FNP, LAC
• Sri Harika Meka, MD
• Sandra Melchor
• Heidi Rebeka Meliah, MSW
• Melissa Ramsey, DDS, PLLC
• Olesya Merkulova
• Brianne C Messenger
• Joseph F Meyer, MD
• Jennifer Lauren Meyers
• Nicholas Michael, DO

• Physician Assistant in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.