NPIMap

Individual provider Active NPI

Sadiq Mandilawi, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • La Verne, CA
National Provider Identifier
1295716736
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A34207 Issued in CA
Practice address
1234 Foothill Blvd
La Verne, CA 91750-3329
Phone
(909) 596-4879
Fax
(909) 596-9199
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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 A34207 CA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A34207 CA Primary

Addresses

Primary practice location

1234 Foothill Blvd
La Verne, CA 91750-3329

Mailing address

1234 Foothill Blvd
La Verne, CA 91750-3329
Phone (909) 596-4879

Other identifiers 2

IdentifierTypeStateIssuer
00A342070MedicaidCA
CB220525OtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090413000055 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 3173670031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
May Medical Management CorporationGroup PAC ID 2668757055, 5 clinicians

Practice addresses (Care Compare)

1234 Foothill Blvd
La Verne, CA 91750-3329
Phone (909) 596-4879

Hospital & facility affiliations

  • Pomona Valley Home Care, Inc Home health agency, San Dimas, CA, CCN 059486
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34207CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Afshin Saadat MD Inc Internal Medicine Current Accepting new patients
May Medical Management Corporation CurrentSince Oct 1, 2018 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients

Locations

1234 Foothill Blvd
Ste 2
La Verne, CA 91750
Phone (909) 596-4879

1234 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-4879

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEEIAD/Endpoint/AEEIAD
  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1295716736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503329",
            "telephone_number": "909-596-4879",
            "fax_number": "909-596-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503329",
            "telephone_number": "909-596-4879",
            "fax_number": "909-596-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDILAWI",
        "first_name": "SADIQ",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A34207",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A34207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A342070",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CB220525",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Verne, CA

Sources for this page

Verify at the official NPI Registry.