Tina Mandelman, APN CNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

274213 Issued in AZ

Practice address

1300 N 48TH St
Phoenix, AZ 85008-5803

Phone

(602) 243-7277

NPI assigned

Apr 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Payson, AZ
  • NPI 1194369074
  NPD
• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1316349855
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1609229764
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • San Tan Valley, AZ
  • NPI 1942653019
  NPD
• Mundelein Pediatrics, S.C.

  • Pediatric Adolescent Medicine Physician
  • Grayslake, IL
  • NPI 1336294800
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1043639255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122902",
            "telephone_number": "602-323-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 48TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850085803",
            "telephone_number": "602-243-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELMAN",
        "first_name": "TINA",
        "credential": "APN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "274213",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.011209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tmandelman@mphc-az.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 N 48th St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850085803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasminder Mand, MD
• Suchita Mandair
• Mandalene Mirkhah DDS PLLC
• Cristina M. Mandanas, MD
• Victor Seguerra Mandapat, DO
• Amy Mandile, DNP-FNP-C
• Angelito Mandolado, LMT
• Mason Mandy, M.D.
• Paris Mandy, MA, LAC, MSN, RN
• Thirunarayana Anandam Mandyam, RPH

• Pediatric Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.