NPIMap

Individual provider Active NPI

Jess Mandel, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • San Diego, CA
National Provider Identifier
1023006970
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
C52434 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X C52434 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X C52434 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other identifiers 2

IdentifierTypeStateIssuer
0246777MedicaidIA
42717OtherIAWELLMARK BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070111000461 CA Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 6608884929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Baylor College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52434CAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Aug 3, 2006 Accepting new patients
Regents of the University of California Pulmonary Disease CurrentSince Aug 3, 2006 Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce Past Accepting new patients
Regents of the University of California Past Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
State University of Iowa Past Accepting new patients

Locations

4168 Front St
San Diego, CA 92103
Phone (619) 471-0420

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 7

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 2

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1023006970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEL",
        "first_name": "JESS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C52434",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "C52434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0246777",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "42717",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.