| Shawn James Mendonca, MD | |
|
2296 Opitz Blvd Ste 350, Woodbridge, VA 22191-3346 | |
| (703) 680-2111 | |
| (703) 878-3939 |
| Full Name | Shawn James Mendonca |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 13 Years |
| Location | 2296 Opitz Blvd Ste 350, Woodbridge, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619219052 | NPI | - | NPPES |
| 297137 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 297137 (New York) | Secondary |
| 208800000X | Urology | MD471068 (Pennsylvania) | Secondary |
| 208800000X | Urology | 0101280217 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sentara Northern Virginia Medical Center | Woodbridge, VA | Hospital |
| Inova Alexandria Hospital | Alexandria, VA | Hospital |
| Novant Prince William Medical Center | Manassas, VA | Hospital |
| Inova Fair Oaks Hospital | Fairfax, VA | Hospital |
| Novant Health Uva Health Haymarket Medical Center | Haymarket, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Potomac Urology Center, Llc | 1557329406 | 17 |
| Potomac Urology Center, Llc | 1557329406 | 17 |
| Gastrointestinal Specialists Llc | 5294797957 | 70 |
| Entity Name | Potomac Urology Center, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861588592 PECOS PAC ID: 1557329406 Enrollment ID: O20041227000203 |
| Entity Name | Potomac Urology Surgery Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1629659800 PECOS PAC ID: 1557767860 Enrollment ID: O20210913002133 |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn James Mendonca, MD 2296 Opitz Blvd Ste 350, Woodbridge, VA 22191-3346 Ph: (703) 680-2111 | Shawn James Mendonca, MD 2296 Opitz Blvd Ste 350, Woodbridge, VA 22191-3346 Ph: (703) 680-2111 |
Dr. Shawn Marhamati, M.D: Urology Medicare: Accepting Medicare Assignments Practice Location: 2296 Opitz Blvd Ste 350, Woodbridge, VA 22191 Phone: 703-680-2111 | |
Ek Seng Lou, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 2296 Opitz Blvd, Suite 350, Woodbridge, VA 22191 Phone: 703-680-2111 Fax: 703-878-3939 | |
Dr. John Brian Klein, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2296 Opitz Blvd, Suite 350, Woodbridge, VA 22191 Phone: 703-680-2111 | |
Dr. Pratik S Desai, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2296 Opitz Blvd, Suite 350, Woodbridge, VA 22191 Phone: 703-680-2111 Fax: 703-878-3939 | |
William C. Reha, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2296 Opitz Blvd, #220, Woodbridge, VA 22191 Phone: 703-670-5107 Fax: 703-670-8435 | |
Alok S Desai, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2296 Opitz Blvd, Suite 350, Woodbridge, VA 22191 Phone: 703-680-2111 Fax: 703-878-3939 |