George Timothy Mandybur, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

ME159756 Issued in FL

Practice address

13685 Doctors Way Ste 350
Fort Myers, FL 33912-4347

Phone

(239) 343-3800

Fax

(239) 343-3993

NPI assigned

Jul 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Neurosurgery

Education

University of Cincinnati College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: gmandybur309515@direct.leememorial.org

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.

• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment Care Compare group NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Lee Health System Inc

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1770165920
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Mayfield Spine Center LLC

  • Ambulatory Surgical Clinic/Center
  • Norwood, OH
  • NPI 1144391178
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1437188596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13685 DOCTORS WAY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124347",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 Edwards Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452091288",
            "country_code": "US",
            "telephone_number": "513-221-1100",
            "fax_number": "513-569-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDYBUR",
        "first_name": "GEORGE",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME159756",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35083759",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116114500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmandybur309515@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Neurological Surgery Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.