NPIMap

Individual provider Active NPI

Jose M Mandry, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Ocoee, FL
National Provider Identifier
1386674794
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0062303 Issued in FL
Practice address
1510 Citrus Medical CT
Ocoee, FL 34761-4547
Phone
(407) 480-4830
Fax
(407) 480-4834
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0062303 FL Primary

Addresses

Primary practice location

1510 Citrus Medical CT
Ocoee, FL 34761-4547

Mailing address

1510 Citrus Medical CT
Ocoee, FL 34761-4547
Phone (407) 480-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040826000949 FL Practitioner - Internal MedicinePractitioner - Endocrinology 3577538354 Reassigns benefits to 1 organization
I20191120001146 FL Practitioner - Endocrinology 3577538354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Ponce School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1510 Citrus Medical CT
Ocoee, FL 34761-4547
Phone (407) 480-4830

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.56 of 100Reported as group
Quality
86.61
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0062303FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Orange Endocrinology, PA Endocrinology, Diabetes & Metabolism CurrentSince Oct 2, 2019 Accepting new patients
Endocrine Associates of FL Endocrinology, Diabetes & Metabolism CurrentSince Mar 20, 2001 Accepting new patients
Advanced Diabetes Treatment Centers LLC Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

766 N Sun Dr
Ste 2060
Lake Mary, FL 32746
Phone (407) 260-6000

1510 Citrus Medical Ct
Ocoee, FL 34761
Phone (407) 480-4830

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jose.mandry@woendo.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73554

Organizations & group practices 3

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 7

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1386674794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 CITRUS MEDICAL CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614547",
            "telephone_number": "407-480-4830",
            "fax_number": "407-480-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 CITRUS MEDICAL CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614547",
            "telephone_number": "407-480-4830",
            "fax_number": "407-480-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRY",
        "first_name": "JOSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "0062303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.