Ross Macdonald Mandeville, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A111236 Issued in CA

Practice address

200 W Arbor Dr
Ucsd Medical Center
San Diego, CA 92103-9001

Phone

(619) 543-6266

NPI assigned

Sep 3, 2008

Last updated

Feb 12, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Neurology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Neuron Clinic GPGroup PAC ID 2961744586, 17 clinicians

Telemedicine Group PCGroup PAC ID 9830351824, 94 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24703/brand/1/csg/1/fhir/r4
• Direct secure messaging: ross.mandeville.1@24703.direct.athenahealth.com
• Direct secure messaging: telemed2u.rossmandeville@160918.advancedmd-direct.com

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.

• Telehealth Specialty Medical Group

  dba TeleMed2U

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  Medicare reassignment Care Compare group NPD
• The Neuron Clinic GP

  • Neurology Physician
  • Temecula, CA
  • NPI 1124582424
  Medicare reassignment Care Compare group NPD
• Access Telecare California, P.C.

  • Neurology Physician
  • Dallas, TX
  • NPI 1861959959

  CA

  Medicare reassignment
• Center for Neurohealth, Inc.

  dba Kaizen Brain Center

  • Behavioral Neurology & Neuropsychiatry Physician
  • La Jolla, CA
  • NPI 1154864874
  NPD (past)
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1205084183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "UCSD MEDICAL CENTER",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "UCSD MEDICAL CENTER",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "ROSS",
        "middle_name": "MACDONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A111236",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A111236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheela Mandava, LCSW
• Jess Mandel, MD
• Amy Mandelbaum
• Paul Mandella
• Katherine Ann Mandeville, MD
• Mitchel Mandic
• Mia Mandler
• Mandometer Inc. (Mandometer Clinic)
• Austin Mandoyan
• Tyler Clark Mandt, MD

• Neurology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.