DR. ALVIN LAUTAN MENDOZA (M.D.) – Internal Medicine Physician, NPI 1053721845
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. ALVIN LAUTAN MENDOZA (M.D.)
4116 SW 179TH WAY
MIRAMAR, FL 33029
Phone: (424) 653-4768
Type: Mailing
4116 SW 179th Way
Miramar, FL 330295078
Phone: (424) 653-4768
Type: Location
2055 E South Blvd Ste 200
Montgomery, AL 361162002
Phone: (334) 284-5211
Type: Location
3000 CORAL HILLS DR
CORAL SPRINGS, FL 330654108
Phone: (954) 344-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-11-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171108001676 | I | Internal Medicine | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33029)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | FL | |
| Internal Medicine | LA | |
| - | FL | |
| Internal Medicine | TX | |
| Internal Medicine | AR | |
| Internal Medicine | FL | |
| Internal Medicine, Hospitalist | FL | |
| Internal Medicine | FL | |
| Internal Medicine | FL | |
| Internal Medicine | IL |
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