Laura Mandell

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

9678 Issued in CT

Practice address

2701 Tamarack Ave
South Windsor, CT 06074-5562

Phone

(508) 259-6656

NPI assigned

Apr 28, 2021

Last updated

Jun 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4
• Direct secure messaging: laura.mandell.1@1694.direct.athenahealth.com

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

• Day Kimball Medical Group Inc

  • Family Medicine Physician
  • Putnam, CT
  • NPI 1376813972
  Medicare reassignment NPD

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1043892094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 TAMARACK AVE",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060745562",
            "telephone_number": "860-647-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 TAMARACK AVE",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060745562",
            "telephone_number": "508-259-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "9678",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "134948",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CT",
            "license": "134948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manchester Ear, Nose & Throat Center LLC
• Manchester Family Care LLC
• Manchester Pediatric Associates LLC
• Mandell & Blau, MD's PC (Open MRI at Buckland Hills)
• Mandell & Blau, MD's PC (Women's Imaging of Buckland Hills)
• Curtis Manganello, OTR
• Richard John Manganiello, M.D.
• Megan Campbell Marsh, PH.D.
• Morgan Martellio
• Chelsey Martin, APRN

• Pediatric Nurse Practitioner in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.