DR. JASON MAX MENDIVIL (NPI# 1790117893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790117893 |
| Entity Type | Individual |
| Full Name | DR. JASON MAX MENDIVIL |
| Credential | DPM |
| Practice Address |
4646 N Mesa St El Paso TX 79912-6104 |
| Practice Telephone | 9153136300 |
| Practice Fax Number | 9155212028 |
| Mailing Telephone | 9153136300 |
| Mailing Fax Number | 9155212028 |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 2205 | TX | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2205 | TX | Podiatric Medicine & Surgery Service Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 358170402 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Southern Arizona Va Health Care System, 3601 S. 6th Avenue, Tucson, AZ 857230001 | 5207921450 |
| Street Address |
4646 N MESA ST |
| City | EL PASO |
| State | TX |
| Zip Code | 79912-6104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508864182 | Thomas E Alost | Orthopaedic Surgery | 4646 N Mesa St, El Paso, TX 79912-3577 | 2005-07-08 |
| 1669036158 | Bhs Physicians Network, Inc. | Durable Medical Equipment & Medical Supplies | 4646 N Mesa St, El Paso, TX 79912-6312 | 2019-04-30 |
| 1255739603 | Louis E. Zuniga Pt PC | Physical Medicine & Rehabilitation | 4646 N Mesa St, Ste D, El Paso, TX 79912-6104 | 2014-12-17 |
| 1720405319 | Greater Dallas Healthcare Enterprises | Durable Medical Equipment & Medical Supplies | 4646 N Mesa St, El Paso, TX 79912-6104 | 2014-03-21 |
| 1851670285 | Gabriela Martinez | Nurse Practitioner | 4646 N Mesa St, El Paso, TX 79912-6104 | 2011-08-16 |
| 1053546036 | Louis E. Zuniga Pt PC | Prosthetic/Orthotic Supplier | 4646 N Mesa St, Suite B, El Paso, TX 79912-6104 | 2009-05-20 |
| 1306008180 | Ikechukwu Ifeanyi Onyedika | Orthopaedic Surgery | 4646 N Mesa St, El Paso, TX 79912-6104 | 2008-07-02 |
| 1063473254 | Caesar A Zuniga | Podiatrist | 4646 N Mesa St, El Paso, TX 79912-6104 | 2006-03-29 |
| 1831165356 | Richard S Westbrook | Orthopaedic Surgery | 4646 N Mesa St, El Paso, TX 79912-6104 | 2006-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903801 | Cristina Valerie Quinones | Registered Nurse | 444 Executive Blvd., Suite 148, El Paso, TX 79912 | 2020-08-20 |
| 1528698255 | Thomas Wayne Woo Sr. | Physical Therapist | 7430 Remcon Circle Bldg A, El Paso, TX 79912 | 2020-01-22 |
| 1760030290 | Susan De La Cruz | Nurse Practitioner | 6600 N Dessert Blvd, El Paso, TX 79912 | 2019-08-28 |
| 1558925438 | Smiles 4 Less Orthodontics, P.a. | Dentist | 7480 Remcon Cir, El Paso, TX 79912 | 2019-04-26 |
| 1831669423 | Jorge Lorenzo Soto | Occupational Therapy Assistant | 4700 N. Mesa St. F-4, El Paso, TX 79912 | 2018-11-27 |
| 1811464126 | Paloma Herrera | Spec/Tech, Health Info | 200 N Festival, El Paso, TX 79912 | 2018-10-25 |
| 1265910178 | Texas Kids Dental Care West Pa | Clinic/Center | 7480 Remcon, El Paso, TX 79912 | 2018-08-02 |
| 1528555463 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 7831 Paseo Del Norte Blvd, Ste A, El Paso, TX 79912 | 2018-04-17 |
| 1679078927 | Kassandra Ashley Wright | Registered Nurse | 330 Bartlett Dr. Apt 2002, El Paso, TX 79912 | 2018-03-28 |
| 1013410802 | Maranatha Physical Medicine & Rehabilitation, Pllc | Physical Medicine & Rehabilitation | 7100 Westwind Dr Ste 155, El Paso, TX 79912 | 2018-03-17 |
| Find all providers in zip 79912 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908293 | The Foot Institute, P.a. | Podiatrist | 8815 Dyer St Ste 348, El Paso, TX 79904-2036 | 2019-12-02 |
| 1356988091 | The Foot Institute, P.a. | Podiatrist | 1387 George Dieter Dr Ste 102, El Paso, TX 79936-7410 | 2019-12-02 |
| 1225581986 | Mariano Sapien | Podiatrist | 1397 George Dieter Dr Ste A, El Paso, TX 79936-7681 | 2016-07-29 |
| 1063830560 | A Plus Foot Care, Pllc | Podiatrist | 7343 Black Mesa Dr, El Paso, TX 79911-3034 | 2014-04-01 |
| 1134396864 | Elizabeth Fernandez-arias | Podiatrist | 3917 N Mesa St, El Paso, TX 79902-1501 | 2008-05-12 |
| 1871615112 | Foot Healthcare Center of El Paso, P.a. | Podiatrist | 10470 Vista Del Sol Drive, Suite 211, El Paso, TX 79925-7928 | 2007-04-06 |
| 1619017050 | Gary Grindstaff D P M P A | Podiatrist | 5547 N Mesa St, El Paso, TX 79912-5422 | 2007-02-07 |
| 1598872228 | Craig F Bisceglia | Podiatrist | 5001 N. Piedras St., El Paso Vahcs--podiatry Clinic, El Paso, TX 79930-4211 | 2006-08-25 |
| 1437185378 | Russell K Johnson | Podiatrist | 114 W Castellano Dr, El Paso, TX 79912-6119 | 2006-06-23 |
| 1093799249 | Paul Jeffrey Resignato | Podiatrist | 1722 N Zaragoza Rd, Ste C, El Paso, TX 79936-8033 | 2005-12-01 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.