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DR. EDGAR A D MENDOZA M.D.
NPI 1891891388
Pediatrics in Jackson, KY

Active since September 15, 2006PECOS Enrolled
1484 LAKESIDE DRIVE, JACKSON, KY 41339(606) 666-9950(606) 666-9136 Get Directions Write a Review

NPPES record last updated: March 13, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2020, Dec 23, 2019 (2 updates tracked since 2019).

About Dr. Edgar A D Mendoza M.d. NPPES

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

DR. EDGAR A D MENDOZA M.D. (NPI 1891891388) is an individual pediatrics provider in Jackson, Kentucky, licensed in Kentucky (33465) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891891388
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. EDGAR A D MENDOZACredential: M.D.
Location Address1484 LAKESIDE DRIVEJackson, KY 41339-6555
Mailing AddressPo Box 690Beattyville, KY 41311-0690 · (606) 464-0151 · Fax (606) 464-0152
Phone(606) 666-9950
Fax(606) 666-9136
Sole ProprietorNo
Enumeration DateSeptember 15, 2006
Last NPPES UpdateMarch 13, 20202 updates tracked since enumeration
NPPES CertifiedMarch 13, 2020
✔ NPI 1891891388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in KY · 33465
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1484 LAKESIDE DRIVE, Jackson, KY 41339
Open in Google Maps ↗

Other Identifiers 2

Medicaid64343650KY
Other1467417691KY · Medicaid Fqhc Group

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Edgar A D Mendoza M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 41339 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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 9

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

DR. DERRICK JACK HAMILTON D.O.
Internal Medicine
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950
REBECCA K SMITH LCSW
Social Worker (Clinical)
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950
ALLISON MICHELLE MANNING APRN, NP-C
Nurse Practitioner (Family)
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950
MS. BEVERLY DAWN ELLIS APRN
Nurse Practitioner (Family)
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950
MS. BRIDGET CHRISTINA TURNER LCSW
Social Worker (Clinical)
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950
DR. BRITTANY MOORE FUGATE D.O.
Internal Medicine
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950
DR. ROGER CARL WORTHINGTON D.M.D.
Dentist (General Practice)
1484 LAKESIDE DRIVE, DENTAL SUITE
JACKSON, KY 41339
Breathitt County (606) 666-9950
JUNIPER HEALTH INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1484 LAKESIDE DRIVE
JACKSON, KY 41339
Breathitt County (606) 666-9950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgar Mendoza's NPI number?

The NPI number for Edgar Mendoza is 1891891388. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Where is Edgar Mendoza located?

Edgar Mendoza practices at 1484 Lakeside Drive, Jackson, KY 41339. The listed phone number is (606) 666-9950.

What is Edgar Mendoza's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Edgar Mendoza enrolled in Medicare?

Yes. Edgar Mendoza is registered in the Medicare PECOS enrollment system.

What insurance does Edgar Mendoza accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Edgar Mendoza as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edgar Mendoza was last updated on March 13, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.