Madhavi Reddy Mandala, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD60253695 Issued in WA

Practice address

202 N Division St Ste 301
Auburn, WA 98001-4939

Phone

(253) 833-7256

NPI assigned

Aug 16, 2006

Last updated

Sep 27, 2012By 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 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Merit-based Incentive Payment System (MIPS)

Final score

86.73 of 100Reported as apm

Quality

73.46

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  Medicare reassignment Care Compare group
• Auburn Regional Medical Group

  • Family Medicine Physician
  • Federal Way, WA
  • NPI 1063737096
  NPD (past)
• Auburn Regional Medical Group

  • Family Medicine Physician
  • Bonney Lake, WA
  • NPI 1255664827
  NPD (past)
• Issaquah Obstetrics and Gynecology PLLC

  • Obstetrics & Gynecology Physician
  • Issaquah, WA
  • NPI 1073581807
  NPD (past)
• Stewards Inpatient Services LLC

  • Hospitalist Physician
  • Toppenish, WA
  • NPI 1609018647

  Internal Medicine

  NPD (past)
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  NPD (past)
• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1134232168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST STE 301",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-833-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST STE 301",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-833-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDALA",
        "first_name": "MADHAVI",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036114994",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60253695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE NUMBER",
            "identifier": "P00406649",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00393076",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114994",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP NUMBER",
            "identifier": "CA1439",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP NUMBER",
            "identifier": "CE9335",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Adelaide Malone, CP00002069
• Madison Naomi Malvern
• Danny Mammo, M.D.
• Anna L Manangan, RN
• Emily Jean Salarda Manantan, RN
• Rahul Mandiga, M.D.
• Connie Todd Mandler, M.S., CCC-SLP
• Bhavjit Kaur Mangat, OD
• Fusha Del Mar
• Amber Schwed Maratas, MD

• Internal Medicine Physician in Auburn, WA
• Providers in Auburn, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.