Ma. Dennica Lee Trivino Mandigma, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT237606 Issued in PA

Practice address

30 N 4TH St
Lebanon, PA 17046-5606

Phone

(717) 274-0474

Fax

(717) 274-0673

NPI assigned

Jul 16, 2026

Sex

Female

Sole proprietor

No

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

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.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1784160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1316867922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606",
            "telephone_number": "717-274-0474",
            "fax_number": "717-274-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606",
            "telephone_number": "717-274-0474",
            "fax_number": "717-274-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIGMA",
        "first_name": "MA. DENNICA LEE",
        "middle_name": "TRIVINO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-16",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT237606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jais Malcolm
• Jeb S Malcolm, LMT
• Janine Malin, LSW
• Victoria Elaine Malone, MD
• April Hope Mandeville-Palm, MSW, LCSW
• Hanisha Rajlakshmi Manickavasagan, M.D.
• Michelle Joan Manjerovic, PTA
• Manor Care of Lebanon PA, LLC
• Manor Care-Linden Village of Lebanon PA LLC
• Annalisa Manuel

• Family Medicine Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.