Vincent Mandracchia, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000581 Issued in IA

Practice address

1801 Hickman Rd
Broadlawns Medical Center
Des Moines, IA 50314-1505

Phone

(515) 282-2319

Fax

(515) 282-3234

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1174518260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "address_2": "BROADLAWNS MEDICAL CENTER",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2319",
            "fax_number": "515-282-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "address_2": "BROADLAWNS MEDICAL CENTER",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2319",
            "fax_number": "515-282-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRACCHIA",
        "first_name": "VINCENT",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "000581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1088146",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha L. Mallory, MD
• Lisa Kaye Malsom, PT
• Thomas Joseph Maly, LISW
• Denise M Mandi, DPM
• Stephen R Mandler, D.O.
• Jared Mangels
• Mangil Seo MD PC
• Mark Mankins, M.D.
• Madison Grace Mann, RN
• Paul C Mann, OD

• Podiatrist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Podiatrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.