Joel Mandelbaum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

129228 Issued in NY

Practice address

211 Hurley Ave
Kingston, NY 12401-2400

Phone

(845) 339-2804

Fax

(845) 339-5058

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Hurley Ave Family Med PLLC

  • Family Medicine Physician
  • Kingston, NY
  • NPI 1487600326
  Medicare reassignment NPD
• Hurley Avenue Family Medicine

  • Family Medicine Physician
  • Saugerties, NY
  • NPI 1245599877
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1629064787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012400",
            "telephone_number": "845-339-2804",
            "fax_number": "845-339-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012400",
            "telephone_number": "845-339-2804",
            "fax_number": "845-339-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELBAUM",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "129228",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "129228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00523588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Maloney, M.S. CCC-SLP
• Sarah Mambondiumwe, LPN
• Managed Physical Network Inc
• Rosemary Anne Mancuso, MS; R.D.; CDN; CDE
• Linda Mandano, LCSW
• Lauren Manley, LMSW
• Deborah Mannello, MS CCC SLP
• Kirk Manning, M.A. BCBA
• Lisa A Mannino, LMHC
• Vanessa Lyn Manzi, LMSW

• Family Medicine Physician in Kingston, NY
• Providers in Kingston, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.