Marco C Mendoza (NPI# 1255627964, PAC ID# 2668776642) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1255627964 |
| PAC ID by PECOS | 2668776642 |
| Professional Enrollment ID | I20170707002653 |
| Full Name | Marco C Mendoza |
| Organization Legal Name | TAHOE FRACTURE AND ORTHOPEDIC MEDICAL CLINIC INC |
| Address |
973 Mica Dr Suite 201 Carson City NV 89705-7258 |
| Phone Number | 7757836190 |
| Gender | M |
| Medical School | UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE |
| Graduation Year | 2010 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 8628979267 |
| Number of Group Practice Members | 29 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 290019 | CARSON TAHOE REGIONAL MEDICAL CENTER |
| 291306 | CARSON VALLEY MEDICAL CENTER |
| 291313 | BANNER CHURCHILL COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 | 7757836190 | TAHOE FRACTURE AND ORTHOPEDIC MEDICAL CLINIC INC |
| 1139 3rd St, South Lake Tahoe, CA 96150-3465 | 7757836190 | TAHOE FRACTURE AND ORTHOPEDIC MEDICAL CLINIC INC |
| Organization Legal Name | TAHOE FRACTURE AND ORTHOPEDIC MEDICAL CLINIC INC |
| Physicians | 25 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tamara Mukete | Physical Therapy | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1749 N Stewart St, Carson City, NV 89706-2688 |
| Jeromy David Dyer | Physician Assistant | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1520 Virginia Ranch Rd, Suite 101b, Gardnerville, NV 89410-5731 |
| James H Sullivan | Anesthesiology | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Ashten Howard | Physician Assistant | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1520 Virginia Ranch Rd, Suite 101b, Gardnerville, NV 89410-5731 |
| Paul J Fry Iii | Orthopedic Surgery | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1520 Virginia Ranch Rd, Suite 101b, Gardnerville, NV 89410-5731 |
| Elli Rinaldi | Physical Therapy | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1749 N Stewart St, Carson City, NV 89706-2688 |
| Candace L Camelon | Nurse Practitioner | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1520 Virginia Ranch Rd, Suite 101b, Gardnerville, NV 89410-5731 |
| Mallory H Cushner | Nurse Practitioner | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Aaron Michael Zagrodnik | Physical Therapy | Tahoe Fracture and Orthopedic Medical Clinic Inc | 1749 N Stewart St, Carson City, NV 89706-2688 |
| Daniel J Cepela | Orthopedic Surgery | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Street Address |
973 MICA DR SUITE 201 |
| City | CARSON CITY |
| State | NV |
| Zip | 89705-7258 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James H Sullivan | Anesthesiology | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Mallory H Cushner | Nurse Practitioner | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Daniel J Cepela | Orthopedic Surgery | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Sherry L Martin | Nurse Practitioner | Carson Tahoe Physician Clinics | 973 Mica Dr, Suite 200, Carson City, NV 89705-7258 |
| Nicholas J Dirig | Orthopedic Surgery | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Randall Goode | Anesthesiology | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Conor P White | Physical Therapy | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Robin Y Tomita | Physical Medicine and Rehabilitation | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 | |
| Jennifer L Mendoza | Anesthesiology | Tahoe Fracture and Orthopedic Medical Clinic Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Robert J White | Physical Therapy | Tahoe Fracture and Orthopedic Medical Clinic, Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Farnaz Khankhanian | Optometry | 3790 Hwy 395 407, Carson City, NV 89705 | |
| Benjamin C Seljestad | Optometry | 700 Old Clear Creek Rd, Carson City, NV 89705-6853 | |
| Jemini Patel | Optometry | Advanced Sierra Eyecare, Inc. | 700 Old Clear Creek Rd, Carson City, NV 89705-6853 |
| Malina Lorring | Physical Therapy | Bodywise Physical Therapy Inc. | 931 Mica Dr, Suite 1, Carson City, NV 89705-7169 |
| Gary F Willen | Obstetrics/gynecology | 961 Mica Dr A, Carson City, NV 89705-7176 | |
| Angela K Fluitt | Occupational Therapy | Lake Tahoe Orthopaedic Institute A Watson-swanson Professional Corp | 935 Mica Dr, Suite 13, Carson City, NV 89705-7181 |
| Melinda K Hoskins | Certified Nurse Midwife | 937 Mica Dr, Suite 16b, Carson City, NV 89705-7182 | |
| Anne Pavlisin | Occupational Therapy | Tahoe Fracture and Orthopedic Medical Clinic, Inc | 973 Mica Dr, Suite 201, Carson City, NV 89705-7258 |
| City | CARSON CITY |
| Zip Code | 89705 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | CARSON CITY + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Marco C Mendoza.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.