Active NPI
Joel M Mandelman, DPM
- Podiatrist
- Brooklyn, NY
National Provider Identifier
1336122209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N03417
- Practice address
- 1050 E 29TH St
Brooklyn, NY 11210-3744 - Phone
- (718) 252-0100
- NPI assigned
- Nov 23, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N03417 | NY | Primary |
Addresses
Primary practice location
1050 E 29TH St
Brooklyn, NY 11210-3744
Mailing address
1050 E 29TH St
Brooklyn, NY 11210-3744
Phone (718) 252-0100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00740950 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N03417 | NY | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1336122209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 E 29TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112103744",
"telephone_number": "718-252-0100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 E 29TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112103744",
"telephone_number": "718-252-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDELMAN",
"first_name": "JOEL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N03417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00740950",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.