DR. MICHAEL JAMES MANDARINO JR. M.D.
NPI 1780622639
Orthopaedic Surgery - Sports Medicine in Bala Cynwyd, PA

Q: What is Michael Mandarino's NPI number?

The NPI number for Michael Mandarino is 1780622639. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Q: What is Michael Mandarino's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Michael Mandarino was last updated on March 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 03, 2006PECOS Enrolled

150 MONUMENT RD STE 207, BALA CYNWYD, PA 19004(215) 878-1212(610) 989-9813 Get Directions Write a Review

NPPES record last updated: March 2, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Michael James Mandarino Jr. M.d. NPPES

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

DR. MICHAEL JAMES MANDARINO JR. M.D. (NPI 1780622639) is an individual sports medicine provider in Bala Cynwyd, Pennsylvania, licensed in Pennsylvania (MD014300E) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780622639

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameDR. MICHAEL JAMES MANDARINO JR.Credential: M.D.

Location Address150 MONUMENT RD STE 207Bala Cynwyd, PA 19004-1725

Mailing Address420 Sugartown RdDevon, PA 19333-1718 · (215) 878-1212 · Fax (610) 989-9813

Phone(215) 878-1212

Fax(610) 989-9813

Sole ProprietorYes

Enumeration DateJune 3, 2006

Last NPPES UpdateMarch 2, 2026

NPPES CertifiedMarch 2, 2026

✔ NPI 1780622639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in PA · MD014300E

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

150 MONUMENT RD STE 207, Bala Cynwyd, PA 19004

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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)

Dr. Michael James Mandarino Jr. M.d. 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANISAH YVONNE POOLE RD, LDN

Dietitian, Registered