Mayedel A San Jose PC
NPI 1083305510ActiveOrganization· Nurse Practitioner, Family· Santa Teresa, NM
Nurse Practitioner, Family in Santa Teresa, New Mexico, registered in NPPES in May 2023. The authorized official on file is Mayedel San Jose, DNP, APRN, FNP-C, Owner/President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1083305510 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 16, 2023 |
| Last updated in NPPES | Oct 18, 2026 |
| Certified by provider | Oct 18, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Clinic/Center, Health Services | 261QH0100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NM) |
|---|
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