Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1891891388 Individual Practitioner Male Practitioner

Dr. Edgar A D Mendoza , MD

Pediatrics • Jackson, KY

Professional Overview & Biography Verified Profile Summary

Dr. Edgar Mendoza, MD is a registered healthcare professional specializing in Pediatrics in Jackson, KY. Practice services are available at 1484 LAKESIDE DRIVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1484 Lakeside Drive

Jackson, KY 413396555

Telephone 6066669950
Fax 6066669136
Associated Practice Facility / Clinic
🏢 Juniper Health Inc Facility NPI 1467417691

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Jackson, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.3 Yrs
Regional Practice Density
2 Specialists

Practicing in Jackson, KY (910 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-03-13
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License KY 33465

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
64343650 (KY)
Commercial Insurance / Payer ID Medicaid Fqhc Group
1467417691 (KY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Heather Banks , APRN

Nurse Practitioner - Family

NPI 1023789658

Advanced Practice Registered Nurse

Courtney Addison , APRN

Nurse Practitioner - Family

NPI 1104420835

Advanced Practice Registered Nurse

Beverly Ellis , APRN

Nurse Practitioner - Family

NPI 1124488903

Advanced Practice Registered Nurse

Rebecca Smith , LCSW

Social Worker - Clinical

NPI 1174836662

Licensed Clinical Social Worker

Kelsea Combs , PA-C

Physician Assistant

NPI 1265015317

Physician Assistant (Certified)

Ashley-Ann Turner , APRN-CNP

Nurse Practitioner - Pediatrics

NPI 1285584557

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location March 13, 2020

Registered at 1484 LAKESIDE DRIVE, JACKSON, KY 413396555 (Tel: 6066669950)

NPI Profile Active July 08, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2014

Registered at 265 HIGHWAY 15 S, JACKSON, KY 413397370 (Tel: 6066669950)

📍
Updated Business Mailing Address July 08, 2014

Registered at PO BOX 690, BEATTYVILLE, KY 413110690 (Tel: 6064640151)

👤
Provider Name / Credentials Updated July 08, 2014

Recorded as EDGAR MENDOZA, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2014

Pediatrics (License #33465 in KY)

🟢
Initial NPI Registration & Enumeration September 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891891388
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2006
Last Update: March 13, 2020
Sole Proprietor: No

Mailing Address

Po Box 690

Beattyville, KY 413110690

Phone: 6064640151

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.