Individual provider Active NPI

Max Ruben Mandelbaum, M.D., PH.D.

  • Vascular Neurology Physician
  • Redding, CA
National Provider Identifier
1891130738
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
A155474 Issued in CA
Practice address
2624 Edith Ave
Redding, CA 96001-3043
Phone
(530) 806-1190
Fax
(530) 229-7946
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X A155474 CA Primary

Addresses

Primary practice location

2624 Edith Ave
Redding, CA 96001-3043

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20180925001058 CA Practitioner - Neurology 0840416624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

2510 Airpark Dr
Suite 301
Redding, CA 96001-2462
Phone (530) 242-3500

3000 Q St
Sacramento, CA 95816-7058
Phone (916) 560-0319

3400 Data Dr
Rancho Cordova, CA 95670-7956

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
A155474CAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 20, 2018 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients

Locations

2624 Edith Ave
Redding, CA 96001
Phone (530) 241-3316

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1891130738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 EDITH AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013043",
            "telephone_number": "530-806-1190",
            "fax_number": "530-229-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELBAUM",
        "first_name": "MAX",
        "middle_name": "RUBEN",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A155474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.