Jeremy Joel Mandia, M.D.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

279197 Issued in NY

Practice address

300 W Hospital Rd BLDG 319
Fort Eisenhower, GA 30905-5741

Phone

(845) 702-7358

NPI assigned

Jun 17, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1710326418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD BLDG 319",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD BLDG 319",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "845-702-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIA",
        "first_name": "JEREMY",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "279197",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NY",
            "license": "279197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leilani Lopes-Haslam, DO
• Juan Manuel Lopez, MD
• Amy Loser, LCSW
• Paige Macky, MD
• Aldrene Ilano Manasan, DMD
• Nikolai Mashtalov
• Amrutha Elizabeth Mathew, M.D.
• Daniel Ethan McCall, M.D.
• Robert Brennan William McKay
• Preston Michael Melhauser, DDS

• All providers in Fort Eisenhower, GA
• Preventive Medicine/Occupational Environmental Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.