Individual provider Active NPI

Barbara C Mandell, MD

  • Internal Medicine Physician
  • Hewlett, NY
National Provider Identifier
1285636175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
126020-1 Issued in NY
Practice address
1490 Broadway
2ND Floor
Hewlett, NY 11557-1432
Phone
(516) 569-2900
Fax
(516) 569-3442
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 126020-1 NY Primary

Addresses

Primary practice location

1490 Broadway
2ND Floor
Hewlett, NY 11557-1432

Mailing address

1490 Broadway
2ND Floor
Hewlett, NY 11557-1432
Phone (516) 569-2900

Other identifiers 1

IdentifierTypeStateIssuer
00276022MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20040925000092 NY Practitioner - Internal Medicine 5799754941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
126020-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 9, 2018 Accepting new patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jul 9, 2018 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

27005 76th Ave
#222
New Hyde Park, NY 11040
Phone (718) 470-7260

300 Community Dr
Plandome, NY 11030

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

972 Brush Hollow Rd
Westbury, NY 11590

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285636175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571432",
            "telephone_number": "516-569-2900",
            "fax_number": "516-569-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571432",
            "telephone_number": "516-569-2900",
            "fax_number": "516-569-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL",
        "first_name": "BARBARA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126020-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00276022",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

Verify at the official NPI Registry.