Individual provider Active NPI

Andrew Edgar Mendians, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Manistee, MI
National Provider Identifier
1386692218
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
5101012343 Issued in MI
Practice address
1806 E Parkdale Ave
Ste 3
Manistee, MI 49660-9364
Phone
(231) 398-9536
Fax
(231) 398-9541
NPI assigned
May 4, 2006
Last updated
Nov 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101012343 MI Primary

Addresses

Primary practice location

1806 E Parkdale Ave
Ste 3
Manistee, MI 49660-9364

Mailing address

1806 E Parkdale Ave
Ste 3
Manistee, MI 49660-9364
Phone (231) 398-9536

Other identifiers 1

IdentifierTypeStateIssuer
4131646MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622001069 MI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 3476598293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Michigan ENT PCGroup PAC ID 4688619406, 5 clinicians

Practice addresses (Care Compare)

1806 E Parkdale Ave
Suite 3
Manistee, MI 49660-9364
Phone (231) 398-9536

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions22
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Michigan ENT PC CurrentSince Aug 2, 1999 Accepting new patients

Locations

250 Nelson Rd
Ste 1
Ludington, MI 49431
Phone (231) 843-6557

1806 E Parkdale Ave
Ste 3
Manistee, MI 49660
Phone (231) 398-9536

Interoperability endpoints

  • Direct secure messaging: amendians@wment.ssdirect.aprima.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1386692218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 E PARKDALE AVE",
            "address_2": "STE 3",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609364",
            "telephone_number": "231-398-9536",
            "fax_number": "231-398-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 E PARKDALE AVE",
            "address_2": "STE 3",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609364",
            "telephone_number": "231-398-9536",
            "fax_number": "231-398-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIANS",
        "first_name": "ANDREW",
        "middle_name": "EDGAR",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101012343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4131646",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

Verify at the official NPI Registry.