Dr. Charles Mandel O.D., P.C.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

MA2430 Issued in MA

Legal business name

DR. CHARLES MANDEL O.D., P.C.

Practice address

37 Cheshire Rd
Allendale Shopping Center
Pittsfield, MA 01201-1831

Phone

(413) 442-6991

Fax

(413) 443-4205

NPI assigned

Nov 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles I Mandel, OD

Title

President

Phone

(413) 442-6991

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1275714149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CHESHIRE RD",
            "address_2": "ALLENDALE SHOPPING CENTER",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012011831",
            "telephone_number": "413-442-6991",
            "fax_number": "413-443-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CHESHIRE RD",
            "address_2": "ALLENDALE SHOPPING CENTER",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012011831",
            "telephone_number": "413-442-6991",
            "fax_number": "413-443-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CHARLES MANDEL O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "MANDEL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-442-6991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MA",
            "license": "MA2430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HNE",
            "identifier": "14122",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332208",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W15568",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Health Service Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.