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LIKHITH SAI MANDAVA
NPI 1700672888
Student in an Organized Health Care Education/Training Program in Jackson, MI

Active since April 16, 2025PECOS Enrolled
205 N EAST AVE, HENRY FORD JACKSON HOSPITAL, JACKSON, MI 49201(517) 205-7116(517) 205-7050 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Likhith Sai Mandava NPPES

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

LIKHITH SAI MANDAVA (NPI 1700672888) is an individual student in an organized health care education/training program in Jackson, Michigan, licensed in Michigan (4351055066) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700672888
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameLIKHITH SAI MANDAVA
Location Address205 N EAST AVE, HENRY FORD JACKSON HOSPITALJackson, MI 49201
Mailing Address205 N East Ave, Henry Ford Jackson HospitalJackson, MI 49201 · (517) 205-7116 · Fax (517) 205-7050
Phone(517) 205-7116
Fax(517) 205-7050
Sole ProprietorNo
Enumeration DateApril 16, 2025
Last NPPES UpdateOctober 8, 2025
NPPES CertifiedOctober 8, 2025
✔ NPI 1700672888 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
License✔ Licensed in MI · 4351055066
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.
205 N EAST AVE, HENRY FORD JACKSON HOSPITAL, Jackson, MI 49201
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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)

Likhith Sai Mandava 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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Likhith Sai Mandava's NPI number?

The NPI number for Likhith Sai Mandava is 1700672888. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Likhith Sai Mandava located?

Likhith Sai Mandava practices at 205 N East Ave, Henry Ford Jackson Hospital, Jackson, MI 49201. The listed phone number is (517) 205-7116.

What is Likhith Sai Mandava's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Likhith Sai Mandava enrolled in Medicare?

Yes. Likhith Sai Mandava is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Likhith Sai Mandava was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.