Individual provider Active NPI

Amado Jose Mendoza, P.T.

  • Physical Therapist
  • Merritt Island, FL
National Provider Identifier
1982714812
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1395 N Courtenay Pkwy
102
Merritt Island, FL 32953-4400
Phone
(321) 986-8812
NPI assigned
Aug 30, 2006
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1395 N Courtenay Pkwy
102
Merritt Island, FL 32953-4400

Mailing address

1395 N Courtenay Pkwy
102
Merritt Island, FL 32953-4400
Phone (321) 986-8812

Other identifiers 2

IdentifierTypeStateIssuer
892101600MedicaidFL
PT 9938OtherFLLICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000353 FL Practitioner - Physical Therapist in Private Practice 6103825716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aandm Therapy, IncGroup PAC ID 8325048861, 4 clinicians

Practice addresses (Care Compare)

1395 N Courtenay Pkwy
Suite 102
Merritt Island, FL 32953-4474
Phone (321) 986-8812

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A&M Therapy, Inc Physical Therapist CurrentSince Nov 6, 2006 Accepting new patients
A&M Therapy, Inc CurrentSince Nov 6, 2006 Accepting new patients

Locations

7777 N Wickham Rd
Ste 16
Melbourne, FL 32940
Phone (321) 622-6508

1395 N Courtenay Pkwy
Ste 102
Merritt Island, FL 32953
Phone (321) 986-8812

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1982714812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY",
            "address_2": "102",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534400",
            "telephone_number": "321-986-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY",
            "address_2": "102",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534400",
            "telephone_number": "321-986-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "AMADO",
        "middle_name": "JOSE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "892101600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PT 9938",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.