Kathryn E Mandich

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X008476 Issued in NY

Practice address

20 Wallkill Avenue
Wallkill, NY 12589-0114

Phone

(845) 895-1131

Fax

(845) 895-3243

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kathryn E Van Dam Professional name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1528135779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "address_2": "20 WALLKILL AVE",
            "city": "WALLKILL",
            "state": "NY",
            "postal_code": "125890114",
            "telephone_number": "845-895-1131",
            "fax_number": "845-895-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WALLKILL AVENUE",
            "city": "WALLKILL",
            "state": "NY",
            "postal_code": "125890114",
            "telephone_number": "845-895-1131",
            "fax_number": "845-895-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDICH",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "VAN DAM",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Deven Lavalle, MA
• Susanne Leissle, LPN
• Deborah M Lewis, O.T.A
• Mackenzie Lindeman, ATC
• Lorinda Mainetti, LCSW
• Michael Manzo, LMT
• Taylor Masi
• Matthew Matera, PA
• Mark McDonald
• Kimberley McGrath Salamone

• Chiropractor in Wallkill, NY
• Providers in Wallkill, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.