Individual provider Active NPI

Richard I Mandelbaum, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1407887805
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
206316 Issued in NY
Practice address
197 Lee Ave
Brooklyn, NY 11211-8029
Phone
(718) 384-6365
Fax
(718) 384-6682
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 206316 NY
Pediatrics Physician 208000000X 206316 NY Primary

Addresses

Primary practice location

197 Lee Ave
Brooklyn, NY 11211-8029

Mailing address

4 Hastings Rd
Monsey, NY 10952-1311
Phone (845) 354-7206

Other identifiers 1

IdentifierTypeStateIssuer
01817972MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051121000994 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4385663194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

165 Taylor St
Brooklyn, NY 11211-1882
Phone (718) 384-6365

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Mandelbaum MD PC CurrentSince Jun 1, 2005 Accepting new patients

Locations

197 Lee Ave
Brooklyn, NY 11211
Phone (718) 344-9751

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 and National Provider Directory roles.

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": "1757548800000",
    "number": "1407887805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HASTINGS RD",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521311",
            "telephone_number": "845-354-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118029",
            "telephone_number": "718-384-6365",
            "fax_number": "718-384-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELBAUM",
        "first_name": "RICHARD",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "206316",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "206316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01817972",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.