Individual provider Active NPI

Johnny Mendoza, MD

  • Family Medicine Physician
  • Ogdensburg, NY
National Provider Identifier
1972008035
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
341268 Issued in NY
Practice address
102 Ford St
Ogdensburg, NY 13669-1402
Phone
(315) 713-9350
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 341268 NY Primary

Addresses

Primary practice location

102 Ford St
Ogdensburg, NY 13669-1402

Mailing address

A2 Villa del Carmen
Cabo Rojo, PR 00623-4310
Phone (939) 599-0160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260108003629 NY Practitioner - Family Practice 4183100142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4 Commerce LN
Canton, NY 13617-3739
Phone (315) 386-8191

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
341268NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the North Country, Inc. CurrentSince Dec 11, 2025 Accepting new patients

Locations

4 Commerce Ln
Canton, NY 13617
Phone (315) 386-1156

102 Ford St
Ogdensburg, NY 13669
Phone (315) 393-9350

Organizations & group practices 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1972008035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A2 VILLA DEL CARMEN",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "006234310",
            "telephone_number": "939-599-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691402",
            "telephone_number": "315-713-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JOHNNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "341268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.