Active NPI
Jerald Aguila Mendoza, PT
- Physical Therapist
- Hempstead, NY
National Provider Identifier
1992142558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 030296
- Practice address
- 717 Front St
Hempstead, NY 11550-4534 - Phone
- (516) 565-4370
- Fax
- (516) 565-2644
- NPI assigned
- May 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 030296 | NY | Primary |
Addresses
Primary practice location
717 Front St
Hempstead, NY 11550-4534
Mailing address
3 Dosoris LN
Glen Cove, NY 11542-1539
Phone (516) 609-9400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030296 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Medical Health Wellness, PC | Past | Accepting new patients |
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.
-
- Rehabilitation Clinic/Center
- Glen Cove, NY
- NPI 1588975668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382313600000",
"number": "1992142558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 DOSORIS LN",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115421539",
"telephone_number": "516-609-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 FRONT ST",
"city": "HEMPSTEAD",
"state": "NY",
"postal_code": "115504534",
"telephone_number": "516-565-4370",
"fax_number": "516-565-2644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "JERALD",
"middle_name": "AGUILA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-22",
"last_updated": "2013-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "030296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hempstead, NY
- Meley & Associates Inc
- Karen Melito
- Ilana Melvin, PSY.D.
- Monica Mena, RN
- Mendoza Chiropractic Office PC
- Manuel A Mendoza Jr., D.C.
- Daniella Sofia Menjivar Machuca, LMSW
- Mental Health Assoc of Nassau County
- Mental Health Association of Nassau County, Inc
- Mental Health Association of Nassau County, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.