Amrendra Kumar Mandal

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

93364 Issued in GA

Practice address

2501 N Patterson St
Valdosta, GA 31602-1735

Phone

(229) 433-1000

NPI assigned

Jul 25, 2017

Sex

Male

Sole proprietor

Yes

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 GA

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

Gastroenterology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandal70425@sgmc.gadirect.net

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.

• SGMC Physician Network Inc

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1417597170

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1518480250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PRESIDENTIAL CTS",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022477",
            "telephone_number": "315-464-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-433-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDAL",
        "first_name": "AMRENDRA",
        "middle_name": "KUMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "93364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan Michael Mahoney
• Joel Don Malin
• Ashley Renee Malone
• Carolina Marie Manceaux, PA-C
• Twyla Lucinda Mancil, PH. D.
• Tashari Shameka Manning
• Mafaz Mansoor, MD
• Alexis Marable
• Stanley Bernard Marable, D.D.S.
• Richard A Marasco, PHARM., FASCP, CGP

• Gastroenterology Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.