Jake Mandziuk, MD

Primary specialty

Pediatric Pathology PhysicianTaxonomy code 207ZP0213X

License

9953 Issued in WI

Practice address

Department of Pathology and Laboratory Medicine
9000 W. Wisconsin Ave
Milwaukee, WI 53226

Phone

(414) 266-2255

NPI assigned

Aug 16, 2022

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1851019871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE",
            "address_2": "9000 W. WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-266-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE",
            "address_2": "9000 W. WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-266-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDZIUK",
        "first_name": "JAKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "WI",
            "license": "9953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shmuel Mandelbaum, M.D.
• Amanda M Manders, APNP
• Jennifer Sweeney Manderscheid, M.S., LPC, CSAC
• Madalyn Kaye Mandich
• Lauren T Mandrelle, M.S., CCC-SLP
• Colleen M Maney, PHARM.D.
• James P Maney, MD
• Kristen M Maney, NP
• Maxwell Austin Maney, DPT
• Sharon Maney, NP

• Pediatric Pathology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatric Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.