Individual provider Active NPI

Shobha Mandal

  • Student in an Organized Health Care Education/Training Program
  • Sayre, PA
National Provider Identifier
1164985206
Registry record updated Apr 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone
(570) 887-4559
NPI assigned
Apr 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1 Guthrie SQ
Sayre, PA 18840-1625

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220912003728 PA Practitioner - HospitalistPractitioner - Internal Medicine 5597091637 Reassigns benefits to 1 organization
I20221116000677 NY Practitioner - HospitalistPractitioner - Internal Medicine 5597091637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Sep 19, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Sep 19, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Sep 19, 2022 Accepting new patients
Robert Packer Hospital Past Accepting new patients
Corning Hospital Past Accepting new patients

Locations

1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: smandal143673@direct-guthrie.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1164985206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAL",
        "first_name": "SHOBHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-06",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

Verify at the official NPI Registry.