Michael E Mandis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036112094 Issued in IL

Practice address

2236 Vadalabene Dr
Suite 2
Maryville, IL 62062-5844

Phone

(618) 288-6136

Fax

(618) 288-6143

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Internal MedicineAlso: Emergency Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anderson Medical Group LLC 136 clinicians

Midwest Emergency Anderson Health Inc 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Home Health Services Home health agency, Maryville, IL, CCN 147420
• Community Hospital of Staunton Hospital, Staunton, IL, CCN 141306
• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187

Merit-based Incentive Payment System (MIPS)

Final score

74.76 of 100Reported as group

Quality

54.98

Promoting interoperability

85

Improvement activities

40

Cost

73.39

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.

• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615

  Emergency Medicine, IL

  Medicare reassignment Care Compare group NPD
• Anderson Medical Group, LLC

  • General Practice Physician
  • Maryville, IL
  • NPI 1700807716

  IL

  Medicare reassignment Care Compare group
• Eldorado Emergency Group PC

  • Emergency Medicine Physician
  • Eldorado, IL
  • NPI 1235868191

  Emergency Medicine, IL

  Medicare reassignment NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608

  Emergency Medicine, IL

  Medicare reassignment NPD
• Allied Back Pain Center

  • Chiropractor
  • Belleville, IL
  • NPI 1881640985
  NPD (past)
• Back Pain Center, Inc.

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1285600247

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630

  Hospital

  Care Compare affiliation
• Anderson Hospital

  • Home Health Agency
  • Maryville, IL
  • NPI 1629056056
  Care Compare affiliation
• Community Hospital of Staunton

  • Critical Access Hospital
  • Staunton, IL
  • NPI 1750308631

  Hospital

  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1821065764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 VADALABENE DR",
            "address_2": "SUITE 2",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625844",
            "telephone_number": "618-288-6136",
            "fax_number": "618-288-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIS",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036112094",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036112094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "I23797",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112094",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112094-3",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00265571",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112094-5",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821065764",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ILLINOIS",
            "identifier": "06032146",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "202790173",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7496677",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "241366",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "701184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD MO",
            "identifier": "199147",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul G Malcharek, MD
• Malench & Malench MDS
• Anthony Malench, MD
• Peter B Malench, MD
• Lorianna Malito, OTR
• Rachel M Mans, CBD
• Marjorie Garcia Counseling PLLC
• Mark Edelstein, MD, PC
• Mark Fedder, MD, PC
• Casey Elizabeth Marks, M.S.CCC-SLP

• All providers in Maryville, IL
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.