Individual provider Active NPI

Anton Mandrov, M.D.

  • Pediatric Cardiology Physician
  • Bakersfield, CA
National Provider Identifier
1639599863
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A201393 Issued in CA
Practice address
12500 Stockdale Hwy
Bakersfield, CA 93314-9649
Phone
(661) 564-3300
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X A201393 CA Primary

Addresses

Primary practice location

12500 Stockdale Hwy
Bakersfield, CA 93314-9649

Mailing address

9300 Valley Childrens PL # SC05
Madera, CA 93636-8761
Phone (559) 353-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, WI, KY, ME4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20190315002584 ND Practitioner - Pediatric MedicinePractitioner - Hospitalist 3173863800 Reassigns benefits to 2 organizations
I20240612000811 WI Practitioner - Pediatric Medicine 3173863800
I20250205002434 KY Practitioner - Pediatric Medicine 3173863800 Reassigns benefits to 1 organization
I20250217002533 ME Practitioner - Pediatric Medicine 3173863800 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A201393CAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc CurrentSince Jan 28, 2025 Accepting new patients
Mainegeneral Medical Center CurrentSince Feb 14, 2025 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group, Inc. CurrentSince Jan 28, 2025 Accepting new patients
Mercy Medical Center Current Accepting new patients
Mainegeneral Medical Center CurrentSince Feb 14, 2025 Accepting new patients
Mercy Medical Center Current Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
Valley Children'S Medical Group Pediatrics Past Accepting new patients
McKenzie County Healthcare Systems Inc Pediatrics Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients

Locations

3369 Solutions Ctr
Chicago, IL 60677

1201 Pleasant Valley Rd
Fl 7
Owensboro, KY 42303
Phone (270) 417-4705

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

149 North St
Waterville, ME 04901
Phone (207) 622-1959

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

1213 15th Ave W
Williston, ND 58801
Phone (701) 572-7641

Interoperability endpoints

  • Direct secure messaging: antonmandrov@normd.allscriptsdirect.net
  • Direct secure messaging: amandrov219834@direct.aspirus.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1639599863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # SC05",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 STOCKDALE HWY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933149649",
            "telephone_number": "661-564-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDROV",
        "first_name": "ANTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A201393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.