Individual provider Active NPI

Cosmina Mandru, M.D

  • Pediatrics Physician
  • Valhalla, NY
National Provider Identifier
1992070742
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-8212 Issued in AR
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-8585
NPI assigned
Mar 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-8212 AR Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

100 Woods Rd
Valhalla, NY 10595-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170803002006 NY Practitioner - Pediatric Medicine 6901032333 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-8212ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Jul 1, 2017 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
St. John'S Riverside Hospital Past Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1992070742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRU",
        "first_name": "COSMINA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-8212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.