NPIMap

Organization Active NPI

Dr Thomas E Mandat MD

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1750870374
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35055707 Issued in OH
Legal business name
DR THOMAS E MANDAT MD
Practice address
5592 Broadview Rd Ste 103
Cleveland, OH 44134
Phone
(216) 741-5200
Fax
(216) 741-5201
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Authorized official

Name
Jazmine Lescallett
Title
Office Manager
Phone
(440) 235-8484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 35055707 OH Primary

Addresses

Primary practice location

5592 Broadview Rd Ste 103
Cleveland, OH 44134

Mailing address

4758 Ridge Rd Ste 161
Cleveland, OH 44144-3327
Phone (440) 235-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181220002137 OH Part B Supplier - Clinic/Group Practice 3274878145 Receives reassigned benefits from 10 practitioners
Practice locations: Parma, OH

National Provider Directory

National Provider Directory

Locations

5592 Broadview Rd
Parma, OH 44134

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1750870374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4758 RIDGE RD STE 161",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441443327",
            "telephone_number": "440-235-8484",
            "fax_number": "440-235-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5592 BROADVIEW RD STE 103",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44134",
            "telephone_number": "216-741-5200",
            "fax_number": "216-741-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR THOMAS E MANDAT MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "LESCALLETT",
        "authorized_official_first_name": "JAZMINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "440-235-8484"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35055707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.