ANDREW JAY MANDERY (NPI# 1215020201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215020201 |
| Entity Type | Individual |
| Full Name | ANDREW JAY MANDERY |
| Credential | MD |
| Practice Address |
8402 Harcourt Rd Ste 120 Indianapolis IN 46260-2006 |
| Mailing Address |
10330 N Meridian St # 300 Indianapolis IN 46290-1024 |
| Practice Telephone | 3173384303 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | 01045232A | IN | Allopathic & Osteopathic Physicians |
| N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
01045232A | IN | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
01045232A | IN | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
01045232A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200101450B | 05 | |
| BCBS | 00000093853 | 01 |
| Street Address |
8402 HARCOURT RD STE 120 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46260-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831537604 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 8402 Harcourt Rd Ste 120, Indianapolis, IN 46260-2006 | 2013-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1225666589 | Alexander Michael Kiel | Student in an Organized Health Care Education/Training Program | Internal Medicine 3 North, 2001 W. 86th Street, Indianapolis, IN 46260 | 2020-03-31 |
| 1043793151 | Lisa R Foreman | Registered Nurse | 1389 W. 86th Street Unit # 238, Indianapolis, IN 46260 | 2018-09-13 |
| 1790268399 | Esther Muturi | Chore Provider | 1214 Racquetclub South Drive Apt C, Indianapolis, IN 46260 | 2018-09-10 |
| 1912483215 | Katherine Donnelly | Community Health Worker | 1612 Lancashire Ct, Indianapolis, IN 46260 | 2018-07-19 |
| 1326539628 | Peaceful Source Midwifery LLC | Advanced Practice Midwife | 1139 Canterbury Ct., Unit B, Indianapolis, IN 46260 | 2018-05-22 |
| 1144722695 | Mindful Services Center LLC | Clinic/Center | 9002 N Meridian St, Ste 200, Indianapolis, IN 46260 | 2018-03-01 |
| 1144731910 | Meenu Jain | Student in an Organized Health Care Education/Training Program | Internal Medicine, 8414 Naab Road, Suite 100, Indianapolis, IN 46260 | 2017-10-19 |
| 1609392422 | 1717 Senior Living, LLC | Assisted Living Facility | 1703 West 86th Street, Indianapolis, IN 46260 | 2017-08-15 |
| 1093246985 | Royalty Transports LLC | Bus | 2255 W. 67th St., Indianapolis, IN 46260 | 2017-03-23 |
| Find all providers in zip 46260 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982050340 | Eric Pittelkow | Surgery | 545 Barnhill Drive Emerson Hall, Suite 232, Indianapolis, IN 46202 | 2016-05-04 |
| 1164654257 | Erin Weber | Surgery | 1801 N Senate Blvd Ste 525, Indianapolis, IN 46202-1253 | 2009-08-21 |
| 1669677142 | Jaime Marie Ranieri | Surgery | 8051 S Emerson Ave Ste 450, Indianapolis, IN 46237-8667 | 2007-06-15 |
| 1770708158 | Kimberly K Short | Surgery | 8455 Clearvista Place, Indianapolis, IN 46256-2419 | 2007-04-13 |
| 1558344697 | William A Wooden | Surgery | 260 Emerson Hall, 545 Barnhill Dr, Indianapolis, IN 46202-5200 | 2005-11-22 |
| 1881690790 | Jeffrey David Wagner | Surgery | 8040 Clearvista Pkwy, Ste 570, Indianapolis, IN 46256 | 2005-06-24 |
| 1699003400 | Zollman Plastic Surgery | Surgery | 8227 Northwest Blvd, Suite 290, Indianapolis, IN 46278-1387 | 2009-12-07 |
| 1285880997 | Hemant Sabharwal | Surgery | 8051 S Emerson Ave, Suite 480, Indianapolis, IN 46237-8600 | 2008-08-13 |
| 1265697973 | Sidhbh Gallagher | Surgery | 545 Barnhill Dr, Suite 232, Indianapolis, IN 46202-5112 | 2008-07-22 |
| 1982819017 | Indianapolis Institute for Plastic Surgery | Surgery | 8051 S Emerson Ave, Ste 450, Indianapolis, IN 46237-8600 | 2007-05-11 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46260 |
Please comment or provide details below to improve the information on ANDREW JAY MANDERY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.