Organization Active NPI

Metrolina Neurological Associates, P a

  • Specialist
  • Rock Hill, SC
National Provider Identifier
1124007778
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
METROLINA NEUROLOGICAL ASSOCIATES, P A
Practice address
1665 Herlong Court
Suite B
Rock Hill, SC 29732
Phone
(803) 980-7930
Fax
(803) 366-6155
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Dr. Howard Mandell, M.D.
Title
Physician Owner
Phone
(803) 980-7948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1665 Herlong Court
Suite B
Rock Hill, SC 29732

Mailing address

1665 Herlong Court
Suite B
Rock Hill, SC 29732
Phone (803) 980-7930

Other identifiers 1

IdentifierTypeStateIssuer
PA8722MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000073 SC Part B Supplier - Clinic/Group Practice 1153222070 Receives reassigned benefits from 1 practitioner
Practice locations: Rock Hill, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1105532Metrolina Neurological Assoc PA1665 Herlong CT Suite B, Rock Hill, SC 29732Certificate of waiverSep 23, 2027

National Provider Directory

National Provider Directory

Locations

1665 Herlong Ct
#B
Rock Hill, SC 29732
Phone (803) 324-1028

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1124007778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 HERLONG COURT",
            "address_2": "SUITE B",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-980-7930",
            "fax_number": "803-366-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 HERLONG COURT",
            "address_2": "SUITE B",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-980-7930",
            "fax_number": "803-366-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROLINA NEUROLOGICAL ASSOCIATES, P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "MANDELL",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "803-980-7948",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA8722",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.