Kelly C Mandavia, MD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14661 Issued in CA

Practice address

4650 W Sunset Blvd
Ms# 54
Los Angeles, CA 90027-6062

Phone

(323) 669-5653

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmandavia502944@direct.cshs.org

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.

• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Center

  • Pharmacy
  • Los Angeles, CA
  • NPI 1376514810
  NPD
• Children'S Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)
• Childrens Hospital of Los Angeles

  • Children's Hospital
  • Los Angeles, CA
  • NPI 1124073366
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073722260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 W SUNSET BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287901",
            "telephone_number": "323-669-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MS# 54",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAVIA",
        "first_name": "KELLY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandala Psyche Nursing Corp
• Victoria Mandanas
• Solanj Mandani
• Anupama Mandapati, M.ED.
• Patricia Mandatori, MFTI
• Sujal Mandavia, M.D.
• Mandeep Singh, MD, Mba, Professional Corporation
• Briana Mandel, LCSW
• Denise Lynne Mandel, PHD
• Howard Clayton Mandel, MD

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.