Vivian Mandas, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

800 Oak Ridge Tpke Ste C100
Oak Ridge, TN 37830-6927

Phone

(865) 483-2288

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Tennessee Ear, Nose and Throat Specialists, PCGroup PAC ID 0749262459, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034
• University Health System, Inc Hospital, Knoxville, TN, CCN 440015

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EHDGCD

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.

• East Tennessee Ear, Nose & Throat Specialists, PC

  • Otolaryngology Physician
  • Oak Ridge, TN
  • NPI 1467552216

  Physician Assistant

  Medicare reassignment Care Compare group NPD

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

• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  Care Compare affiliation
• University Health System, Inc.

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1538164090
  Care Compare affiliation

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1508620303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 SILICON VALLEY WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314288",
            "telephone_number": "347-981-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TPKE STE C100",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306927",
            "telephone_number": "865-483-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAS",
        "first_name": "VIVIAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macs Pharmacy Oak Ridge LLC
• Marcella G. Maki, BSN, RN
• James B. Makin, DPH.
• Charles J. Mallo, M.D.
• Francis Brent Mallo
• Hiteshwar Singh Mangat, MD
• Jacquelyn Mantooth, LPC
• Chad Manuel, DO
• David Henry Marcotte, LCSW
• Sheila A Marczak, M.M.F.T

• Physician Assistant in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.