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JORDAN KELLY MANDEVILLE
NPI 1972387504
Nurse Practitioner - Psychiatric/Mental Health in Springfield, IL

Active since August 23, 2023PECOS EnrolledAccepts Medicare Assignment
3901 PINTAIL DR STE A, SPRINGFIELD, IL 62711(217) 544-3143(217) 544-4436 Get Directions Write a Review

NPPES record last updated: June 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jordan Kelly Mandeville NPPES

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

JORDAN KELLY MANDEVILLE (NPI 1972387504) is an individual psychiatric/mental health provider in Springfield, Illinois, licensed in Illinois (209028150) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1972387504
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJORDAN KELLY MANDEVILLE
Location Address3901 PINTAIL DR STE ASpringfield, IL 62711-6768
Mailing Address61 Bourbaki RdNew Berlin, IL 62670-4570 · (217) 801-8732
Phone(217) 544-3143
Fax(217) 544-4436
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 23, 2023
Last NPPES UpdateJune 26, 2026
NPPES CertifiedJune 26, 2026
✔ NPI 1972387504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IL · 209028150
3901 PINTAIL DR STE A, Springfield, IL 62711
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Kelly Mandeville is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921545641
PECOS Enrollment IDI20240731000034
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.

Medicare Billing Reassignment

Medicare enrollment records show Jordan Mandeville reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Killian And Associates Sc
Same address
Psychiatry
3901 PINTAIL DR STE A
Springfield, IL 62711
  • Reassigned Medicare billing, Illinois enrollment
  • 9 clinicians in this Medicare group
NPI 1487642708 (217) 544-3143

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62711 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

PATRICIA JEAN FOLLIN LCPC
Counselor (Professional)
3901 PINTAIL DR STE A
SPRINGFIELD, IL 62711
Sangamon County (217) 544-3143
DR. TERRY M KILLIAN MD
Psychiatry & Neurology (Psychiatry)
3901 PINTAIL DR STE A
SPRINGFIELD, IL 62711
Sangamon County (217) 544-3143
KARMA LYNN CARPENTER LCSW
Social Worker (Clinical)
3901 PINTAIL DR STE A
SPRINGFIELD, IL 62711
Sangamon County (217) 544-3143
KILLIAN AND ASSOCIATES SC
Psychiatry & Neurology (Psychiatry)
3901 PINTAIL DR STE A
SPRINGFIELD, IL 62711
Sangamon County (217) 544-3143

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 Jordan Mandeville's NPI number?

The NPI number for Jordan Mandeville is 1972387504. It was assigned to this individual provider in the NPPES registry on August 23, 2023.

Where is Jordan Mandeville located?

Jordan Mandeville practices at 3901 Pintail Dr Ste A, Springfield, IL 62711. The listed phone number is (217) 544-3143.

What is Jordan Mandeville's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jordan Mandeville enrolled in Medicare?

Yes. Jordan Mandeville is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jordan Mandeville's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Mandeville reassigns Medicare benefits to Killian And Associates Sc (Springfield, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jordan Mandeville's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jordan Mandeville accept?

Health plans from Oscar Health list Jordan Mandeville as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jordan Mandeville was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.