Robert Marc Mandelkorn, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME80929 Issued in FL

Practice address

3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413

Phone

(239) 939-3939

Fax

(239) 931-6106

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Ophthalmology

Education

University of Louisville School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Robert M Mandelkorn, M.D., Inc.

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1871807420
  Medicare reassignment NPD Authorized official
• R Thad Goodwin MD PA

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1285813410
  NPD (past)

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

• Adventhealth Port Charlotte Inc

  dba Adventhealth Port Charlotte

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1760299093
  Care Compare affiliation

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1457455990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 WINKLER AVENUE EXT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169413",
            "telephone_number": "239-939-3939",
            "fax_number": "239-931-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WINKLER AVENUE EXT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169413",
            "telephone_number": "239-939-3939",
            "fax_number": "239-931-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELKORN",
        "first_name": "ROBERT",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME80929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timur Mamedov, M.D.
• Michael S. Mancano
• Kimberly Ann Mancl, MD
• Mandala Counseling Services LLC
• Archana Reddy Mandala, M.D.
• George Timothy Mandybur, M.D.
• Elise N Manee, PHARMD
• Donna Joy Mangatt, O.D.
• Mangrove Chiropractic PLLC
• Tanja Mani, PHD

• Ophthalmology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.