Individual provider Active NPI

Linda D Mandanas, MD

  • Family Medicine Physician
  • Oswego, NY
National Provider Identifier
1013061431
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
177012-1 Issued in NY
Practice address
144 W 5TH St
Oswego, NY 13126-2552
Phone
(315) 342-1765
Fax
(315) 342-1742
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 177012-1 NY Primary

Addresses

Primary practice location

144 W 5TH St
Oswego, NY 13126-2552

Mailing address

144 W 5TH St
Oswego, NY 13126-2552
Phone (315) 342-1765

Other identifiers 1

IdentifierTypeStateIssuer
02270006MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051123000394 NY Practitioner - Family Practice 8325068109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

144 W 5TH St
Oswego, NY 13126-2552

Hospital & facility affiliations

  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

Merit-based Incentive Payment System (MIPS)

Final score
80.61 of 100Reported as apm
Quality
61.22
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
177012-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renato Y Mandanas Current Accepting new patients

Locations

144 W 5th St
Oswego, NY 13126
Phone (315) 342-1765

Interoperability endpoints

  • Direct secure messaging: lmandanas@oswegoprimecare.amazing-direct.com
  • Direct secure messaging: lmandanas@hiemail.healtheconnections.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013061431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 W 5TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262552",
            "telephone_number": "315-342-1765",
            "fax_number": "315-342-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 W 5TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262552",
            "telephone_number": "315-342-1765",
            "fax_number": "315-342-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDANAS",
        "first_name": "LINDA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "177012-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02270006",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.