| Mendes Medical Assoc. Pc | |
|
55 Belgade Ave Roslindale MA 02131-2413 | |
| (617) 327-7465 | |
| (617) 363-9993 |
| Full Name | Mendes Medical Assoc. Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 55 Belgade Ave, Roslindale, Massachusetts |
| Authorized Official Name and Position | Antonio C Mendes (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6173277465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendes Medical Assoc. Pc 55 Belgrade Ave Roslindale MA 02131-2413 Ph: (617) 327-7465 | Mendes Medical Assoc. Pc 55 Belgade Ave Roslindale MA 02131-2413 Ph: (617) 327-7465 |
| NPI Number | 1225212335 |
|---|---|
| Provider Enumeration Date | 12/26/2007 |
| Last Update Date | 07/31/2012 |
| Medicare PECOS PAC ID | 8022184225 |
|---|---|
| Medicare Enrollment ID | O20080912000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225212335 | NPI | - | NPPES |
| 9729259 | Medicaid | MA | |
| M19669 | Other | MA | BCBS |
| 110069096A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 80176 (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | 80176 (Massachusetts) | Primary |
| Provider Name | Antonio C Mendes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659347961 PECOS PAC ID: 0244274462 Enrollment ID: I20050617000328 |
| Provider Name | Natalia Kocherovsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902133390 PECOS PAC ID: 1153462858 Enrollment ID: I20100104000049 |
| Provider Name | Narine Avetisyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770941627 PECOS PAC ID: 6204168693 Enrollment ID: I20191105000975 |
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