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DR. THEODORE DUNGAN MANDELKORN MD
NPI 1922167220
Pediatrics - Developmental - Behavioral Pediatrics in Mercer Island, WA

Active since December 06, 2006PECOS Enrolled
2553 76TH AVE SE, MERCER ISLAND, WA 98040(206) 275-0702 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Theodore Dungan Mandelkorn Md NPPES

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

DR. THEODORE DUNGAN MANDELKORN MD (NPI 1922167220) is an individual developmental - behavioral pediatrics provider in Mercer Island, Washington, licensed in Washington (MD00010762) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922167220
Entity TypeIndividualMale
Primary Taxonomy2080P0006X
Provider Legal NameDR. THEODORE DUNGAN MANDELKORNCredential: MD
Location Address2553 76TH AVE SEMercer Island, WA 98040-2758
Mailing Address2553 76th Ave SeMercer Island, WA 98040-2758 · (206) 275-0702
Phone(206) 275-0702
Sole ProprietorYes
Enumeration DateDecember 6, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1922167220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in WA · MD00010762
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
2553 76TH AVE SE, Mercer Island, WA 98040
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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. Theodore Dungan Mandelkorn 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.

Other Providers at the Same Location NPPES 4

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

DR. HAL COOPER QUINN MD
Pediatrics
2553 76TH AVE SE
MERCER ISLAND, WA 98040
King County (206) 275-2122
MERCER ISLAND PEDIATRIC ASSOCIATES
Pediatrics
2553 76TH AVE SE
MERCER ISLAND, WA 98040
King County (206) 275-2122
DR. DANETTE SWANSON GLASSY MD
Pediatrics (Adolescent Medicine)
2553 76TH AVE SE
MERCER ISLAND, WA 98040
King County (206) 275-2122
DR. JOHN GERARD SCHREUDER MD
Pediatrics
2553 76TH AVE SE
MERCER ISLAND, WA 98040
King County (206) 275-2122

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 Theodore Mandelkorn's NPI number?

The NPI number for Theodore Mandelkorn is 1922167220. It was assigned to this individual provider in the NPPES registry on December 6, 2006.

Where is Theodore Mandelkorn located?

Theodore Mandelkorn practices at 2553 76th Ave SE, Mercer Island, WA 98040. The listed phone number is (206) 275-0702.

What is Theodore Mandelkorn's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Theodore Mandelkorn enrolled in Medicare?

Yes. Theodore Mandelkorn is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Theodore Mandelkorn was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.