Michael James Mandarino Jr., M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

MD014300E Issued in PA

Practice address

150 Monument Rd Ste 207
Bala Cynwyd, PA 19004-1725

Phone

(215) 878-1212

Fax

(610) 989-9813

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

State licenses

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.

• Michael J. Mandarino, M.D., P.C.

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1912206046
  NPD Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1780622639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SUGARTOWN RD",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331718",
            "telephone_number": "215-878-1212",
            "fax_number": "610-989-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD STE 207",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041725",
            "telephone_number": "215-878-1212",
            "fax_number": "610-989-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDARINO",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "MD014300E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Line Surgery Center, LLC
• Main Line Surgical Center LLC
• Mainline Health Associates
• Mainline Health Associates
• Mainline Vein and Wound Care Center LLC
• Richard J Mandel, M.D.
• Samuel J Manfrey, D.O.
• Andrew Marinchenko, DMD
• Romina Elizabeth Martinez, BCBA
• Marvin H. Greenbaum, M.D. PC

• Sports Medicine (Orthopaedic Surgery) Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.