Active NPI
Matthew Gary Mandelbaum, PHD
- Psychologist
- New York, NY
National Provider Identifier
1952711202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 220 Manhattan Ave
2U
New York, NY 10025-2623 - Phone
- (917) 608-1331
- NPI assigned
- May 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
220 Manhattan Ave
2U
New York, NY 10025-2623
Mailing address
220 Manhattan Ave
2U
New York, NY 10025-2623
Phone (917) 608-1331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective May 2, 2017 through May 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020910 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399420800000",
"number": "1952711202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 MANHATTAN AVE",
"address_2": "2U",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100252623",
"telephone_number": "917-608-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MANHATTAN AVE",
"address_2": "2U",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100252623",
"telephone_number": "917-608-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDELBAUM",
"first_name": "MATTHEW",
"middle_name": "GARY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-07",
"last_updated": "2014-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.