Individual provider Active NPI

Gregory Mandile, D.O.

  • Internal Medicine Physician
  • Lakewood Ranch, FL
National Provider Identifier
1629519038
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS16535 Issued in FL
Practice address
8130 Lakewood Main St Ste 103
Lakewood Ranch, FL 34202-5068
Phone
(941) 499-2700
Fax
(941) 487-0474
NPI assigned
Mar 17, 2017
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS16535 FL Primary
Hospitalist Physician 208M00000X OS16535 FL

Addresses

Primary practice location

8130 Lakewood Main St Ste 103
Lakewood Ranch, FL 34202-5068

Mailing address

2413 Lakewood Ranch Blvd N
Lakewood Ranch, FL 34240-7025
Phone (941) 499-2700

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200820003199 FL Practitioner - Internal Medicine 2466881032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accountable Inpatient MedicineGroup PAC ID 5597090274, 51 clinicians

Practice addresses (Care Compare)

8130 Lakewood Main St
Suite 103
Lakewood Ranch, FL 34202-5068

8433 Enterprise Circle
Suite 100 317
Lakewood Ranch, FL 34202-4200
Phone (941) 499-2700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.38 of 100Reported as group
Quality
87.5
Improvement activities
40
Cost
77.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Inpatient Medicine Multi-Specialty CurrentSince Jul 15, 2020 Accepting new patients

Locations

8130 Lakewood Main St
Ste 103
Lakewood Ranch, FL 34202
Phone (918) 289-7085

8433 Enterprise Cir
Ste 100
Lakewood Ranch, FL 34202
Phone (941) 499-2700

Organizations & group practices 1

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.

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": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1629519038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 LAKEWOOD RANCH BLVD N",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342407025",
            "telephone_number": "941-499-2700",
            "fax_number": "941-487-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 LAKEWOOD MAIN ST STE 103",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025068",
            "telephone_number": "941-499-2700",
            "fax_number": "941-487-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDILE",
        "first_name": "GREGORY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-17",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16535",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS16535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.