CHRISTIAN MENDOZA (PA-C) – Physician Assistant, NPI 1912784562

CHRISTIAN MENDOZA (PA-C) is a healthcare provider. based in Brandon, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9117793 (FL). The NPI Number for CHRISTIAN MENDOZA (PA-C) is 1912784562

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTIAN MENDOZA (PA-C)
NPI
1912784562
Phone
(813) 654-2544
Address
109 MARGARET ST
Enumeration Date
8 September 2023
Last Update Date
23 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8138797546
Graduation Year
2023 (3 years ago)
PAC ID
0749706166
Group Practice PAC ID
6103914742
Professional Enrollment ID
I20250429002287
Address ID
FL336076429TA4164XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

9,232 PHYSICIAN ASSISTANT in FL

Provider Addresses for CHRISTIAN MENDOZA (PA-C)

  • 109 MARGARET ST

    BRANDON, FL 335115203

    Phone: (813) 654-2544

    Fax: (813) 653-4391

    Type: Mailing

  • 4164 N Armenia Ave

    Tampa, FL 336076429

    Phone: (813) 879-7546

    Fax: (813) 817-6842

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $147.

Total Amount is formed as General ($147) + Research ($0) + Ownership ($0) = $147.

Last reported payment date: 2024-05-01 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($122).

Total Amount

$147

General + Research + Ownership

Payments

2

Total payment records

General Amount

$147

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-01

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-04-29

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250429002287IPhysician AssistantFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 33511)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103914742View full group profile
NameSpecialtyState
Dermatology, Micrographic Dermatologic Surgery (Mds)FL

Reviews

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Frequently asked questions

What NPI should I save for CHRISTIAN MENDOZA (PA-C)?
Save NPI 1912784562 if you need a stable reference for CHRISTIAN MENDOZA (PA-C).
Does this profile mean CHRISTIAN MENDOZA (PA-C) is currently active?
Yes — CHRISTIAN MENDOZA (PA-C) appears active in the national provider directory.
What field does CHRISTIAN MENDOZA (PA-C) work in?
You can think of CHRISTIAN MENDOZA (PA-C) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for CHRISTIAN MENDOZA (PA-C)?
We surface Brandon, Florida for CHRISTIAN MENDOZA (PA-C) based on available NPPES addresses.
How can I contact CHRISTIAN MENDOZA (PA-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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