Deja Mandy, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN11023581 Issued in FL

Practice address

1839 Central Avenue
St Petersburg, FL 33713-8900

Phone

(727) 322-1054

Fax

(727) 821-7213

NPI assigned

Mar 4, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Deja Mandy Professional name

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Health Care of Pinellas, LLCGroup PAC ID 1658274675, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours Home Care by Compassus Home health agency, Saint Petersburg, FL, CCN 108384

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Professional Health Care of Pinellas LLC

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1881647253
  Medicare reassignment Care Compare group NPD
• Pcma Palliative Division LLC

  dba Pcma Medical Group LLC Sole MBR

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Pittsburgh, PA
  • NPI 1629585054

  FL

  Medicare reassignment NPD
• Professional Health Care of Pinellas Inc.

  • Chiropractor
  • St Petersburg, FL
  • NPI 1568970903
  NPD

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

• Compassus BSMH St. Petersburg HHA II, LLC

  dba Bon Secours Home Care by Compassus

  • Home Health Agency
  • St Petersburg, FL
  • NPI 1427876341
  Care Compare affiliation

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1538926993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVENUE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVENUE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDY",
        "first_name": "DEJA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-05-24",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11023581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121835800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4EA8C",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEJA",
            "last_name": "MANDY",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sara Alexandra Maltese, D.M.D
• Maltezos Wellness Psychiatry LLC
• Lily Maltezos, PMHNP
• Justin Mandel, L.AC
• Steven Mark Mandel, M.D.
• Mona Vishin Mangat, MD
• Manjula S Mangipudy, MD
• Rhoderick James Manhattan, PA-C
• Gina Lisa Maniaci, LCSW
• Shane Manion

• Gerontology Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.