Individual provider Active NPI

George Mandler, LDN, LICAC

  • Acupuncturist
  • Stow, MA
National Provider Identifier
1538197405
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
230194 Issued in MA
Practice address
132 Great Rd
Suite 201
Stow, MA 01775-1189
Phone
(978) 461-2001
Fax
(866) 709-1684
NPI assigned
Jun 29, 2006
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2598 MA
Acupuncturist 171100000X 230194 MA Primary

Addresses

Primary practice location

132 Great Rd
Suite 201
Stow, MA 01775-1189

Mailing address

132 Great Rd Ste 201
Stow, MA 01775-1189
Phone (978) 461-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2016 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2598MAMDClinical Neuropsychologist
230194MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Innerspring Acupuncture & Wellbeing Inc. Acupuncturist CurrentSince Aug 25, 2024 Accepting new patients

Locations

132 Great Rd
Ste 201
Stow, MA 01775
Phone (978) 461-2001

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1538197405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 GREAT RD STE 201",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017751189",
            "telephone_number": "978-461-2001",
            "fax_number": "866-709-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 GREAT RD",
            "address_2": "SUITE 201",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017751189",
            "telephone_number": "978-461-2001",
            "fax_number": "866-709-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDLER",
        "first_name": "GEORGE",
        "credential": "LDN, LICAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2598",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MA",
            "license": "230194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, MA

Sources for this page

Verify at the official NPI Registry.