Hollie Mandiberg, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008015-1 Issued in NY

Practice address

153 W 11TH St
St. Vincent'S Hospital
New York, NY 10011-8305

Phone

(212) 604-7000

Fax

(973) 740-1350

NPI assigned

May 25, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Good Samaritan Hospital

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1841424249
  NPD (past)
• Metro Emergency Medical Association PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1134159502
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1558572909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 837",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390837",
            "telephone_number": "800-345-0064",
            "fax_number": "973-740-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 W 11TH ST",
            "address_2": "ST. VINCENT'S HOSPITAL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118305",
            "telephone_number": "212-604-7000",
            "fax_number": "973-740-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117066012",
            "country_code": "US",
            "telephone_number": "631-581-5900",
            "fax_number": "631-968-1792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDIBERG",
        "first_name": "HOLLIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008015-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "008015-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Mandell, MS CCC-SLP
• Talia Mandell, MD
• William F Mandell, MD
• Katherine Lee Manders, PA-C
• Edgar Mandeville, MD
• Christopher Eliot Mandigo, M.D.
• Grace Kim Mandigo, M.D.
• Mary Axel Mandis, ED.D
• Lisa Ann Mandl, M.D.
• Ari Mandler

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.