NPIMap

Individual provider Active NPI

Michael Anthony Mandarano, D.O.

  • Internal Medicine Physician
  • Dunmore, PA
National Provider Identifier
1184957102
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS015862 Issued in PA
Practice address
1141 Clay Ave
Suite 1
Dunmore, PA 18512-1191
Phone
(570) 343-1722
Fax
(570) 343-7110
NPI assigned
Sep 9, 2009
Last updated
Nov 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS015862 PA Primary
Pediatrics Physician 208000000X OS015862 PA

Addresses

Primary practice location

1141 Clay Ave
Suite 1
Dunmore, PA 18512-1191

Mailing address

1141 Clay Ave
Suite 1
Dunmore, PA 18512-1191
Phone (570) 343-1722

Other identifiers 1

IdentifierTypeStateIssuer
1026658790002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111221000147 PA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7618143793 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

116 Atlantic Ave
Dingmans Ferry, PA 18328-9801
Phone (570) 855-7538

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. Internal Medicine CurrentSince Dec 11, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 29, 2022 Accepting new patients
Family Care Centers Inc Internal Medicine CurrentSince Dec 27, 2021 Accepting new patients
Northwell Health Medical PA, P.C. Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Donna Eget PC CurrentSince Jan 15, 2013 Accepting new patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Internal Medicine Current Accepting new patients
Family Care Centers Inc. Internal Medicine CurrentSince Dec 27, 2021 Accepting new patients
Lehigh Valley Physician Group Internal Medicine CurrentSince Sep 29, 2022 Accepting new patients
Donna Eget PC PastSince Jan 15, 2013 Accepting new patients

Locations

116 Atlantic Ave
Dingmans Fry, PA 18328
Phone (570) 855-7538

1141 Clay Ave
Ste 1
Dunmore, PA 18510
Phone (570) 341-9110

1208 Oneill Hwy
Dunmore, PA 18512
Phone (570) 207-2612

179 Independence Rd
East Stroudsburg, PA 18301
Phone (570) 421-8526

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

300 Lackawanna Ave
Ste 200
Scranton, PA 18503
Phone (570) 342-7864

600 Commerce Blvd
Stroudsburg, PA 18360
Phone (570) 424-7390

Organizations & group practices 10

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.

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1184957102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 CLAY AVE",
            "address_2": "SUITE 1",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121191",
            "telephone_number": "570-343-1722",
            "fax_number": "570-343-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 CLAY AVE",
            "address_2": "SUITE 1",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121191",
            "telephone_number": "570-343-1722",
            "fax_number": "570-343-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDARANO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS015862",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS015862",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026658790002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.