Vijay Kumar S Mandalaywala, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

157002 Issued in NY

Practice address

17 Hospital Dr Ste 5
Massena, NY 13662-1039

Phone

(315) 769-4656

Fax

(315) 769-4671

NPI assigned

Nov 8, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Town of Massena

  dba Massena Memorial Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Massena, NY
  • NPI 1871659391
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1265501571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HOSPITAL DR. , STE 5",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621039",
            "telephone_number": "315-769-4656",
            "fax_number": "315-769-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HOSPITAL DR STE 5",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621039",
            "telephone_number": "315-769-4656",
            "fax_number": "315-769-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDALAYWALA",
        "first_name": "VIJAY KUMAR",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "157002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Loomis, LICENSED OPTICIAN
• Rebecca Monica Love, LCSW-R
• M B Kayani Physician PC (Watertown Eye Center)
• Jessica Macmillan-Barney, LMT
• Priti V Mandalaywala, MD
• Sally Manor, RN
• Taylor Marcellus
• Maria Cuda, DO, PC (St Alphonsus Family Medicine)
• Rosalind Sia Mariano, M.D.
• Andrew George Marlow, CPHT

• Surgery Physician in Massena, NY
• Providers in Massena, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.