Individual provider Active NPI

Molly Helen Weidner Mandernach, M.D.

  • Hematology & Oncology Physician
  • Gainesville, FL
National Provider Identifier
1912088063
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME97424 Issued in FL
Practice address
1600 SW Archer Road
Gainesville, FL 32610
Phone
(352) 273-7832
Fax
(352) 273-7849
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME97424 FL
Hematology & Oncology Physician 207RH0003X ME97424 FL Primary

Addresses

Primary practice location

1600 SW Archer Road
Gainesville, FL 32610

Mailing address

PO Box 918025
Orlando, FL 32891-0001
Phone (352) 273-7832

Other identifiers 1

IdentifierTypeStateIssuer
005939200MedicaidFL

Other names 1

  • Molly Helen Weidner Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120710000771 FL Practitioner - HematologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 3971768383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Internal Medicine
Education
University of Florida College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1535 Gale Lemerand Dr
Gainesville, FL 32610-3008
Phone (352) 273-9500

1549 Gale Lemerand Dr
Gainesville, FL 32610-3008
Phone (352) 265-4357

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME97424FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Heme Onc Call Hematology & Oncology CurrentSince Aug 1, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2012 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

9850 Stirling Rd
Ste 100
Hollywood, FL 33024
Phone (786) 567-8310

8255 S Dixie Hwy
Miami, FL 33143
Phone (305) 458-1384

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mmandernach9503@direct.shands.ufl.edu
  • FHIR API: https://fhir4.healow.com/fhir/r4/IJABCD

Organizations & group practices 3

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 8

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1912088063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "352-273-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32610",
            "telephone_number": "352-273-7832",
            "fax_number": "352-273-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDERNACH",
        "first_name": "MOLLY",
        "middle_name": "HELEN WEIDNER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME97424",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME97424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005939200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "WEIDNER",
            "middle_name": "HELEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.