Active NPI
Arnold Mandelstam, M.D.
- Psychiatry Physician
- Jamaica, NY
National Provider Identifier
1063472710
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Dec 20, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 149158
- Practice address
- 80-44 190 St
Jamaica, NY 11423-1309 - Phone
- (718) 479-6699
- Fax
- (718) 776-6551
- NPI assigned
- Mar 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 149158 | NY | Primary |
Addresses
Primary practice location
80-44 190 St
Jamaica, NY 11423-1309
Mailing address
8044 190TH St
Jamaica, NY 11423-1039
Phone (718) 479-6699
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00759875 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1063472710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8044 190TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114231039",
"telephone_number": "718-479-6699",
"fax_number": "718-776-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80-44 190 ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114231309",
"telephone_number": "718-479-6699",
"fax_number": "718-776-6551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDELSTAM",
"first_name": "ARNOLD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-26",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "149158",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00759875",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.