Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. ANGELICA M MENDIETA NURSE PRACTITIONER
NPI 1104613629
Nurse Practitioner - Family in Milwaukee, WI

Q: What is Angelica Mendieta's NPI number?

The NPI number for Angelica Mendieta is 1104613629. It was assigned to this individual provider in the NPPES registry on April 21, 2025.

Q: What is Angelica Mendieta's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Angelica Mendieta was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 21, 2025PECOS Enrolled

1032 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204(414) 672-1353(262) 408-5094 Get Directions Write a Review

NPPES record last updated: July 31, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Angelica M Mendieta Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ANGELICA M MENDIETA NURSE PRACTITIONER (NPI 1104613629) is an individual family provider in Milwaukee, Wisconsin, licensed in Wisconsin (16506-33) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1104613629

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. ANGELICA M MENDIETACredential: NURSE PRACTITIONER

Location Address1032 S CESAR E CHAVEZ DRMilwaukee, WI 53204-2203

Mailing Address1032 S Cesar E Chavez DrMilwaukee, WI 53204-2203 · (414) 672-1353 · Fax (262) 408-5094

Phone(414) 672-1353

Fax(262) 408-5094

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateApril 21, 2025

Last NPPES UpdateJuly 31, 2026

NPPES CertifiedJuly 31, 2026

✔ NPI 1104613629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WI · 16506-33

1032 S CESAR E CHAVEZ DR, Milwaukee, WI 53204

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Secondary Practice Locations 4

Location 14570 S 27th StMilwaukee, WI 53221-2145 · Phone (414) 672-1353

Location 2309 E North StWaukesha, WI 53188-3718 · Phone (414) 672-1353

Location 32906 S 20th StMilwaukee, WI 53215-3732 · Phone (414) 672-1353

Location 41635 W National AveMilwaukee, WI 53204-1130 · Phone (414) 672-1353

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Angelica M Mendieta Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335625201

PECOS Enrollment IDI20260109002650

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY GEBHARDT PA-C

Physician Assistant