NPIMap

Individual provider Active NPI

Phyllis Karen Mandel, MD

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1174748404
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
184941 Issued in NY
Practice address
1060 E 100 S
Suite L10
Salt Lake City, UT 84102-1501
Phone
(801) 328-1260
Fax
(801) 350-4361
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 184941 NY Primary

Addresses

Primary practice location

1060 E 100 S
Suite L10
Salt Lake City, UT 84102-1501

Mailing address

1060 E 100 S
Suite L10
Salt Lake City, UT 84102-1501
Phone (801) 328-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Bagg MD & Phyllis Mandel MD PC Internal Medicine Past Accepting new patients
Allied Healthcare Physician PLLC PastSince Dec 9, 2020 Accepting new patients

Organizations & group practices 2

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1174748404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E 100 S",
            "address_2": "SUITE L10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021501",
            "telephone_number": "801-328-1260",
            "fax_number": "801-350-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 100 S",
            "address_2": "SUITE L10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021501",
            "telephone_number": "801-328-1260",
            "fax_number": "801-350-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEL",
        "first_name": "PHYLLIS",
        "middle_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "184941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.