Kenneth Mandato

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

ME136921 Issued in FL

Practice address

910 Old Camp Rd Ste 120
The Villages, FL 32162-5605

Phone

(352) 787-5858

Fax

(352) 728-6749

NPI assigned

Oct 25, 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 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Diagnostic Radiology

Education

Boston University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of Central Florida L L CGroup PAC ID 7214833003, 6 clinicians

Lake Medical Imaging and Breast Center at the Villages LLCGroup PAC ID 0042116865, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
• Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
• Uf Health Spanish Plaines Rehab Hospital Inpatient rehabilitation facility, The Villages, FL, CCN 10T290

Merit-based Incentive Payment System (MIPS)

Final score

96.22 of 100Reported as group

Quality

95.56

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.5 of 100Reported as group

Quality

90

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kmandato562652@direct.shands.ufl.edu

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.

• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • Leesburg, FL
  • NPI 1770541633
  Medicare reassignment Care Compare group NPD
• Radiology Associates of Central Florida L L C

  • Diagnostic Radiology Physician
  • Leesburg, FL
  • NPI 1184689127
  Medicare reassignment Care Compare group NPD
• Hem Onc Associates of the Treasure Coast, PA

  • Medical Oncology Physician
  • Port St Lucie, FL
  • NPI 1205882867
  Medicare reassignment NPD
• Hem Onc Associates of the Treasure Coast, PA

  • Hematology & Oncology Physician
  • Stuart, FL
  • NPI 1477807477
  NPD
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1912570045
  NPD
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1366015232
  NPD (past)
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1659940807
  NPD (past)
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1942879192
  NPD (past)
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1811917461
  NPD (past)
• Albany Medical Center South Clinical Campus

  • Diagnostic Ultrasound Physician
  • Albany, NY
  • NPI 1669408332

  Diagnostic Radiology

  NPD (past)
• Central New York Pet LLC

  • Nuclear Medicine Physician
  • Liverpool, NY
  • NPI 1174515712
  NPD (past)
• Mohawk Glen Radiology Associates of Cny PLLC

  • Diagnostic Radiology Physician
  • Rome, NY
  • NPI 1538466115
  NPD (past)

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

• Leesburg Regional Medical Center Inc

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1245001189

  Hospital

  Care Compare affiliation
• Leesburg Regional Medical Center Inc

  • General Acute Care Hospital
  • Leesburg, FL
  • NPI 1245226190
  Care Compare affiliation
• LRMC Urgent Care Center

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1598841389

  Hospital

  Care Compare affiliation
• Villages Tri-County Medical Center Inc.

  • Rehabilitation Hospital
  • The Villages, FL
  • NPI 1275902124

  Inpatient rehabilitation facility

  Care Compare affiliation
• Villages Tri-County Medical Center Inc.

  • General Acute Care Hospital
  • The Villages, FL
  • NPI 1740276518
  Care Compare affiliation

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1871677682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E DIXIE AVE STE 104",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487601",
            "telephone_number": "352-787-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 OLD CAMP RD STE 120",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625605",
            "telephone_number": "352-787-5858",
            "fax_number": "352-728-6749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E Dixie Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347487601",
            "country_code": "US",
            "telephone_number": "352-787-5858",
            "fax_number": "352-728-6749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDATO",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME136921",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME136921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104390500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Barton Mahan, HAS-BC 1808
• Seemab Nazar Malik, M.D.
• Corey Jamian Mallette, LCSW
• Kirkland Malone
• Thomas J Mammana, NRP
• Edelyn Marie Manning Pagan, MD
• Miguel Mantilla-Villamizar, MD
• Brandon Max Markus, D.O.
• Tyler Marsh
• Phoebe Martey

• Vascular & Interventional Radiology Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.