Individual provider Active NPI

Grace Kim Mandigo, M.D.

  • Neurological Surgery Physician
  • New York, NY
National Provider Identifier
1528212511
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
246538-1 Issued in NY
Practice address
710 W 168TH St FL 4
Neurological Institute, Department of Neurosurgery
New York, NY 10032-3726
Phone
(212) 305-8101
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 246538-1 NY Primary

Addresses

Primary practice location

710 W 168TH St FL 4
Neurological Institute, Department of Neurosurgery
New York, NY 10032-3726

Mailing address

300 E 77TH St Apt 6a
New York, NY 10075-2451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100115000106 NY Practitioner - NeurosurgeryPractitioner - Interventional Radiology 1153463088 Reassigns benefits to 2 organizations
I20160225001959 NJ Practitioner - Neurosurgery 1153463088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: Interventional Radiology
Education
Columbia University College of Physicians and Surgeons, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, shared by 10 NPIs, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
246538-1NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Mar 16, 2019 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Mar 16, 2019 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince May 31, 2016 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince May 31, 2016 Accepting new patients
Neurosurgical Associates of New Jersey, P.C. Neurological Surgery CurrentSince Dec 7, 2015 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

1200 E Ridgewood Ave
Ste 200
Ridgewood, NJ 07450
Phone (201) 327-8600

121 State Route 36
Ste 330
West Long Branch, NJ 07764
Phone (732) 222-8866

710 W 168th St
Ste 425
New York, NY 10032
Phone (212) 305-1090

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

710 W 168th St
Fl 4
New York, NY 10032
Phone (212) 304-7190

710 W 168th St
New York, NY 10032
Phone (212) 305-0217

177 Fort Washington Ave
New York, NY 10032
Phone (212) 305-3090

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ghk7001@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1528212511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E 77TH ST APT 6A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100752451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST FL 4",
            "address_2": "NEUROLOGICAL INSTITUTE, DEPARTMENT OF NEUROSURGERY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-305-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIGO",
        "first_name": "GRACE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "246538-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.