Individual provider Active NPI

Jolie Mandell, PT

  • Physical Therapist
  • Fredonia, NY
National Provider Identifier
1902996051
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0210331 Issued in NY
Practice address
276 W Main St
Fredonia, NY 14063-2234
Phone
(716) 680-8180
Fax
(716) 680-8181
NPI assigned
Oct 12, 2006
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0210331 NY Primary
Physical Therapist 225100000X 8129 NC

Addresses

Primary practice location

276 W Main St
Fredonia, NY 14063-2234

Mailing address

276 W Main St
Fredonia, NY 14063-2234
Phone (716) 680-8180

Other names 1

  • Jolie Lange Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110531000540 NY Practitioner - Physical Therapist in Private Practice 7113963620 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8129NCMDPharmacist
0210331NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Werks Physical Therapy PLLC Physical Therapist CurrentSince Oct 10, 2014 Accepting new patients
Wilson Orthopaedic Surgery & Neurology Center PA Past Accepting new patients

Locations

8746 Erie Rd
#A
Angola, NY 14006
Phone (716) 549-4999

183 E Main St
Ste 105
Fredonia, NY 14063

183 E Main St
Ste 110
Fredonia, NY 14063
Phone (716) 549-4999

276 W Main St
Fredonia, NY 14063
Phone (716) 680-8180

276 W Main St
Frnt Door
Fredonia, NY 14063

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1902996051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 W MAIN ST",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140632234",
            "telephone_number": "716-680-8180",
            "fax_number": "716-680-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 W MAIN ST",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140632234",
            "telephone_number": "716-680-8180",
            "fax_number": "716-680-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL",
        "first_name": "JOLIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0210331",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLIE",
            "last_name": "LANGE",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fredonia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.