Vijay Mandyam, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E4071 Issued in CA

Practice address

43713 20TH St W Ste 5
Lancaster, CA 93534-4628

Phone

(661) 945-8700

Fax

(661) 945-8757

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeside Medical Organization a Medical Group IncGroup PAC ID 7618005166, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vijay.mandyam.p1@direct.lakeside.nextgenshare.com

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.

• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642

  Podiatrist

  Medicare reassignment Care Compare group NPD
• Valleyfootdoctor, Inc

  • Podiatrist
  • Lancaster, CA
  • NPI 1427819820
  Medicare reassignment NPD Authorized official
• Dr. Vijay Mandyam

  • Podiatrist
  • Lancaster, CA
  • NPI 1619456704
  NPD Authorized official
• Valley Presbyterian Hospital

  • General Acute Care Hospital
  • Van Nuys, CA
  • NPI 1578529285
  NPD (past)

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

• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1174618672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43713 20TH ST W STE 5",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344628",
            "telephone_number": "661-945-8700",
            "fax_number": "661-945-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43713 20TH ST W STE 5",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344628",
            "telephone_number": "661-945-8700",
            "fax_number": "661-945-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDYAM",
        "first_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E40711",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Malone
• Rendell Esmane Manalo, D.O.
• Leo Manasra
• Deborah Marie Manchester, CCC-A
• John Michael Mancini
• Christopher Mangassarian
• Kamil Nabil Azer Mankarious, DMD
• Georgi Manker-Stokes
• Bonnie June Mann
• John Joseph Manning, M.D.

• Podiatrist in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.