Emmanuel Mendoza, PA-C is a medicare enrolled "Physician Assistant" in Vancleave, Mississippi. His current practice location is
6300 E Lake Blvd Ste 201, Vancleave, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(228) 230-2663.
Emmanuel Mendoza is licensed to practice in Mississippi (license number PA00846) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225856602.
Provider's Profile
| Full Name | Emmanuel Mendoza |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 6300 E Lake Blvd Ste 201, Vancleave, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1225856602
- Provider Enumeration Date: 10/02/2024
- Last Update Date: 02/25/2025
Medicare PECOS Information:
- PECOS PAC ID: 5395269179
- Enrollment ID: I20250414002988
Medical Identifiers
Medical identifiers for Emmanuel Mendoza such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1225856602 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363A00000X | Physician Assistant | PA00846 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Emmanuel Mendoza is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Emmanuel Mendoza, PA-C 6300 E Lake Blvd Ste 301, Vancleave, MS 39565-6771 Ph: (228) 230-2663 | Emmanuel Mendoza, PA-C 6300 E Lake Blvd Ste 201, Vancleave, MS 39565-6771 Ph: (228) 230-2663 |
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