Individual provider Active NPI

Neil Brian Mansdorf, D.P.M.

  • Sports Medicine Podiatrist
  • Orange, CA
National Provider Identifier
1295766475
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine PodiatristTaxonomy code 213ES0000X
License
E4222 Issued in CA
Practice address
555 N Tustin St
Orange, CA 92867-7611
Phone
(714) 633-0040
Fax
(714) 633-0045
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X E4222 CA
Sports Medicine Podiatrist 213ES0000X E4222 CA Primary

Addresses

Primary practice location

555 N Tustin St
Orange, CA 92867-7611

Mailing address

555 N Tustin St
Orange, CA 92867-7611
Phone (714) 633-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100712000533 CA Practitioner - Podiatry 4587796479 Practice locations: Orange, CA
O20100930017970 CA DME Supplier - Physician - Podiatry 6103937768 Practice locations: Orange, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

555 N Tustin St
Orange, CA 92867-7611
Phone (714) 633-0040

Merit-based Incentive Payment System (MIPS)

Final score
40.01 of 100Reported as individual
Quality
45.48
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue73
Removal of skin lesions1-10
Removal of nail tissue499
Removal or shaving of skin growth153
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4222CAMDFoot Surgery Podiatrist

Interoperability endpoints

  • Direct secure messaging: drsesamoid@mansdorf.emadirect.md

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1295766475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677611",
            "telephone_number": "714-633-0040",
            "fax_number": "714-633-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677611",
            "telephone_number": "714-633-0040",
            "fax_number": "714-633-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSDORF",
        "first_name": "NEIL",
        "middle_name": "BRIAN",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E4222",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CA",
            "license": "E4222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.