MR. GARY FREDERICK MANDILE (NPI# 1225252018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225252018 |
| Entity Type | Individual |
| Full Name | MR. GARY FREDERICK MANDILE |
| Credential | CCP |
| Practice Address |
5801 S Mcclintock Dr Suite 110 Tempe AZ 85283-6002 |
| Mailing Address |
Po Box 27341 Tempe AZ 85285-7341 |
| Practice Telephone | 4807770607 |
| Mailing Telephone | 4807770607 |
| Mailing Fax Number | 6024807771 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2010-04-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
5801 S MCCLINTOCK DR SUITE 110 |
| City | TEMPE |
| State | AZ |
| Zip Code | 85283-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497757199 | Perfusion Associates, Inc. | Perfusionist | 5801 S Mcclintock Dr, Suite 110, Tempe, AZ 85283-6002 | 2005-08-11 |
| 1831615038 | Brooke Reed | Specialist/Technologist, Other | 5801 S Mcclintock Dr, Ste 110, Tempe, AZ 85283 | 2017-08-18 |
| 1801319520 | Michelle Mclean | Perfusionist | 5801 S Mcclintock Dr, Ste 110, Tempe, AZ 85283 | 2017-07-25 |
| 1467849414 | Aim Enterprises Inc | Specialist | 5801 S Mcclintock Dr, Ste 110, Tempe, AZ 85283-6002 | 2015-04-16 |
| 1780015628 | Melissa Colson | Student in an Organized Health Care Education/Training Program | 5801 S Mcclintock Dr, Ste 110, Tempe, AZ 85283-6002 | 2013-12-03 |
| 1235568627 | Sally Zerfas | Student in an Organized Health Care Education/Training Program | 5801 S Mcclintock Dr, Ste 110, Tempe, AZ 85283-6002 | 2013-11-06 |
| 1831538313 | Jordan Brimhall | Perfusionist | 5801 S Mcclintock Dr, #110, Tempe, AZ 85283-6002 | 2013-06-18 |
| 1932404050 | Arizona Heart Perfusion, LLC | Perfusionist | 5801 S Mcclintock Dr, 110, Tempe, AZ 85283-6002 | 2011-01-20 |
| 1013022177 | Timothy B. Diesfeld | Perfusionist | 5801 S Mcclintock Dr, #110, Tempe, AZ 85283-6002 | 2006-08-20 |
| 1356370878 | Harry William Schechner | Perfusionist | 5801 S Mcclintock Dr, 110, Tempe, AZ 85283-6002 | 2006-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373284 | Odilette Trevizo | Registered Nurse | Beautiful You Med Spa, 123 E Baseline Rd Ste D208, Tempe, AZ 85283 | 2019-06-03 |
| 1538631981 | Baseline Dental Care Pllc | Dentist | 1980 E Baseline Road Suite 101, Tempe, AZ 85283 | 2018-12-26 |
| 1912409228 | Laura Lee Jones | Social Worker | 438 W. Seed Farm Road, Sacaton, AZ 85283 | 2018-03-02 |
| 1609226364 | Clean Colonic LLC | Public Health or Welfare | 7560 S. Willow Dr, Tempe, AZ 85283 | 2016-06-14 |
| 1235583212 | Seema Bacon | Counselor | 2111 E Baseline Rd Ste D2, Tempe, AZ 85283 | 2016-04-15 |
| 1326436908 | Dale E King | Social Worker | 1405 E. Guadalupe Road, Tempe, AZ 85283 | 2015-01-05 |
| 1194135871 | Greater Phoenix Psychiatric Associate Pllc | Psychiatry & Neurology | 6530 S Maple Ave, Tempe, AZ 85283 | 2014-05-02 |
| 1639468077 | Muna A Jama | Pharmacist | 6404 S Mcclintock Dr., Tempe, AZ 85283 | 2011-04-06 |
| 1649580945 | Nancy A Syms | Psychologist | 6350 South Maple Avenue, Tempe, AZ 85283 | 2010-10-20 |
| 1629208400 | Bonnie J Rouzaud | Nurse Practitioner | 1920 E Baseline Road, Tempe, AZ 85283 | 2009-07-15 |
| Find all providers in zip 85283 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407098510 | Steven Ricky Sowell | Perfusionist | 1929 E Libra Dr, Tempe, AZ 85283-3229 | 2009-04-03 |
| 1801931332 | Brian P Smith | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2007-02-21 |
| 1497757199 | Perfusion Associates, Inc. | Perfusionist | 5801 S Mcclintock Dr, Suite 110, Tempe, AZ 85283-6002 | 2005-08-11 |
| 1043826886 | Megan Todd | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2020-09-17 |
| 1407409121 | Michele M Nied | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2019-07-22 |
| 1568927408 | Nicholas Valdez | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2019-02-05 |
| 1083193767 | Qianli Yu | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2018-08-13 |
| 1649759325 | Piero Cecchi | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2018-08-13 |
| 1003395054 | Jason Sarnecki | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2018-08-10 |
| 1750860706 | Kelly Dean Hedlund | Perfusionist | 5801 S Mcclintock Dr Ste 110, Tempe, AZ 85283-6002 | 2018-08-10 |
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| 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.