IAN MANDYBUR MD
NPI 1093566184
Student in an Organized Health Care Education/Training Program in Cleveland, OH

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 28, 2024PECOS Enrolled

11100 EUCLID AVE, CLEVELAND, OH 44106(216) 844-3887 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Ian Mandybur Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IAN MANDYBUR MD (NPI 1093566184) is an individual student in an organized health care education/training program in Cleveland, Ohio and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093566184

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameIAN MANDYBURCredential: MD

Location Address11100 EUCLID AVECleveland, OH 44106-1716

Mailing Address11100 Euclid AveCleveland, OH 44106-1716

Phone(216) 844-3887

Sole ProprietorNo

Enumeration DateMarch 28, 2024

NPPES CertifiedMarch 28, 2024

✔ NPI 1093566184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

11100 EUCLID AVE, Cleveland, OH 44106

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ian Mandybur Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.