Walter Andrew Jay Mandery, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

71009973A Issued in IN

Practice address

13345 Illinois St
Carmel, IN 46032-3318

Phone

(317) 396-1300

Fax

(317) 396-1346

NPI assigned

Mar 12, 2020

Last updated

Mar 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indianapolis Neurosurgical Group PCGroup PAC ID 0941191282, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Riverview Health Hospital, Noblesville, IN, CCN 150059

Merit-based Incentive Payment System (MIPS)

Final score

95.75 of 100Reported as group

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: walter.mandery.p1@direct.goodmancampbell.nextgenshare.com

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.

• Indianapolis Neurosurgical Group PC

  dba Goodman Campbell Brain and Spine

  • Neurological Surgery Physician
  • Carmel, IN
  • NPI 1275580318
  Medicare reassignment Care Compare group
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Riverview Hospital

  • General Acute Care Hospital
  • Noblesville, IN
  • NPI 1700883717
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Hospital

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent - Avon

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1457986259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13345 ILLINOIS ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323318",
            "telephone_number": "317-396-1300",
            "fax_number": "317-396-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13345 ILLINOIS ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323318",
            "telephone_number": "317-396-1300",
            "fax_number": "317-396-1346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-338-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDERY",
        "first_name": "WALTER",
        "middle_name": "ANDREW JAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-12",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28199259A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009973A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71009973A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "walter.mandery.p1@direct.goodmancampbell.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "13345 Illinois St",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460323318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Kelly Malone, CNM
• McKenna Malott
• Oppah Maluleke, LSW
• Managed Therapy Resources
• Margaret Mandarich
• Kimberly Jo Manges, DNP, APRN, AGACNP-BC
• Olga Mangusheva, OTR
• Deborah E Mann, O.D.
• Tammy Lynele Manning, COTA
• Joseph Mansour, MD

• Acute Care Nurse Practitioner in Carmel, IN
• Providers in Carmel, IN by specialty
• Acute Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.