Shmuel Mandelbaum, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

54771 Issued in WI

Practice address

6980 N Port Washington Rd Ste 202
Milwaukee, WI 53217

Phone

(414) 351-7100

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stuart Paul Mandelbaum Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Psychiatry

Education

Wayne State University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wisconsin Community Services IncGroup PAC ID 7517981822, 2 clinicians

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Wisconsin Community Services Inc.

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1538389184
  Medicare reassignment Care Compare group NPD
• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment NPD
• Lakeshore Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Sheboygan, WI
  • NPI 1245520519
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Lakeshore Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • West Bend, WI
  • NPI 1184358004
  NPD
• Lakeshore Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manitowoc, WI
  • NPI 1245502673
  NPD
• Wisconsin Community Services Inc.

  dba Unlimited Potential

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1417108747
  NPD
• Lakeshorehealthcare

  • Group Psychotherapy Psychologist
  • Chicago, IL
  • NPI 1881643906
  NPD (past)
• Rehab Services SL, S.C.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1982932497
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1942221601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 N PORT WASHINGTON RD STE 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173900",
            "telephone_number": "414-351-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 N PORT WASHINGTON RD STE 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 Reed Ave",
            "address_purpose": "LOCATION",
            "city": "Manitowoc",
            "state": "WI",
            "postal_code": "542202020",
            "country_code": "US",
            "telephone_number": "920-320-8600",
            "fax_number": "920-320-8662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "339 Reed Ave",
            "address_purpose": "LOCATION",
            "city": "Manitowoc",
            "state": "WI",
            "postal_code": "542202020",
            "country_code": "US",
            "telephone_number": "920-320-8600",
            "fax_number": "920-320-8662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDELBAUM",
        "first_name": "SHMUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "54771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "339 Reed Ave",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542202020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smandelbaum180958@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "339 Reed Ave",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542202020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STUART",
            "last_name": "MANDELBAUM",
            "middle_name": "PAUL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margot Elizabeth Manassa, R.N.
• Thomas Mance, D.O.
• Josephine Mary Mancuso, NP
• Mark Steven Mandel, D.D.S.
• Neil S Mandel, PHD
• Amanda M Manders, APNP
• Jennifer Sweeney Manderscheid, M.S., LPC, CSAC
• Madalyn Kaye Mandich
• Lauren T Mandrelle, M.S., CCC-SLP
• Jake Mandziuk, MD

• Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.