Mary Grace Mendoza, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3285-0 Issued in HI

Practice address

86-260 Farrington Hwy
Waianae, HI 96792-3128

Phone

(808) 697-3768

Fax

(808) 697-3347

NPI assigned

Jul 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, HI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Waianae District Comprehensive Health and Hospital Board IncorporatedGroup PAC ID 9931008349, 162 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marygrace.mendoza.p1@direct.wcchc.nextgenshare.com

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382

  HI

  Medicare reassignment Care Compare group NPD
• Waianae District Comprehensive Health and Hospital Board, Inc

  • Family Medicine Physician
  • Waianae, HI
  • NPI 1275566424

  HI

  Medicare reassignment Care Compare group NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  NY

  Medicare reassignment NPD
• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  NY

  Medicare reassignment NPD
• Waianae District Comprehensive Health and Hospital Board, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1710709365
  Care Compare group NPD
• Waianae District Comprehensive Health and Hospital Board Inc

  • Community/Retail Pharmacy
  • Waianae, HI
  • NPI 1962519306
  Care Compare group
• Waianae District Comprehensive Health and Hospital Board, Inc

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1285066985
  Care Compare group
• Waianae District Comprehensive Health and Hospital Board, Inc

  • Federally Qualified Health Center (FQHC)
  • Ewa Beach, HI
  • NPI 1366942831
  Care Compare group
• Waianae District Comprehensive Health and Hospital Board, Inc

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1649859588
  Care Compare group
• Waianae District Comprehensive Health and Hospital Board, Inc

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1851764179
  Care Compare group
• Waianae District Comprehensive Health and Hospital Board, Inc

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1902288830
  Care Compare group
• Waianae District Comprehensive Health and Hospital Board, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1144033051
  Care Compare group

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1992282875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-3598 NANA HOPE ST UNIT 1414",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066846",
            "telephone_number": "718-509-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3768",
            "fax_number": "808-697-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARY GRACE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342032-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "3285-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne McClellan, PSY.D.
• Rizalie A McIntosh
• Patricia Kay McKenzie, APRN
• Joseph C McLary, PA-C
• Stacy Melton
• Jordan Messier, PSYD
• Matthew Buan Messier, PSYD
• John Meteer
• Richanda Mikaele
• Erica Milikaa-Keo

• All providers in Waianae, HI
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.