Amar D Mandavia, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

150 S Huntington Ave
Boston, MA 02130-4817

Phone

(251) 545-8569

NPI assigned

Mar 15, 2024

Last updated

Mar 15, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1811756562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 GLENHAVEN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434938",
            "telephone_number": "251-545-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "251-545-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAVIA",
        "first_name": "AMAR",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna L Mancuso
• Christopher J Mancuso, M.S.
• Thomas J Mancuso, MD
• Ayan Sankar Mandal, MD, PHD
• Soumya Mandava, MD
• Abigail D Mandel
• Ernest Israel Mandel, MD
• Mallory Mandel
• Diana Lauren Mandelker, MD, PHD
• Talya Frances Mandelkern, MD

• Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.