Mark Mangkhalakhili, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

032617 Issued in NY

Practice address

400 International Dr
Williamsville, NY 14221-5771

Phone

(716) 631-3555

NPI assigned

Jan 18, 2022

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

Medicare fee-for-service enrollment

Enrolled in NH, NY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brain and Spine Medical Services PLLCGroup PAC ID 9032103056, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmangkhalakhili@invisionhealthbrainandspine.medentdirect.com

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.

• Brain & Spine Medical Services PLLC

  • Neurological Surgery Physician
  • Williamsville, NY
  • NPI 1073631644
  Medicare reassignment Care Compare group
• Specialty Institute PLLC

  • Interventional Pain Medicine Physician
  • Newington, NH
  • NPI 1932833621
  Medicare reassignment
• Dia Invision Health

  • Diagnostic Radiology Physician
  • Williamsville, NY
  • NPI 1679903579
  NPD
• Global Care Medical Group, P.C.

  • Primary Care Clinic/Center
  • Tewksbury, MA
  • NPI 1902870884
  NPD (past)
• Pratt Medical Group, Inc

  • Pulmonary Disease Physician
  • Boston, MA
  • NPI 1508187642
  NPD (past)

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1508517897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGKHALAKHILI",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-18",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9474",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2127",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Mancuso, FNP
• Rahim Mangalji
• Kelly Lynn Manganello, P.A.
• Lindsay Mangano, MA, CCC-SLP
• Gina Marie Mangione, MD
• Nadya Mariam Manhart, P.T.
• Janet G Manicki, LCSWR
• Antonino Mannone, M.D.
• Kayla Nicole Mansell, PA-C
• Mak Mansouri, LMT

• Physician Assistant in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.