JAMES P MANDERLE (MD) – Certified Registered Nurse Anesthetist, NPI 1013905769

JAMES P MANDERLE (MD) is a healthcare provider. based in Augusta, Georgia. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials MD. They hold a License No. 122034 (WI). The NPI Number for JAMES P MANDERLE (MD) is 1013905769

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
JAMES P MANDERLE (MD)
NPI
1013905769
Phone
(920) 729-3332
Address
804 SCOTT NIXON MEMORIAL DR
Enumeration Date
7 October 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9202232000
Graduation Year
1992 (34 years ago)
PAC ID
3870697758
Group Practice PAC ID
8628103777
Professional Enrollment ID
I20070403000031
Address ID
WI549047944OS500XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,141 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WI

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Provider Addresses for JAMES P MANDERLE (MD)

  • 804, Scott Nixon Memorial Drive, Augusta, Richmond County, Georgia, 30907, United States

    AUGUSTA, GA 309072464

    Phone: (920) 729-3332

    Type: Mailing

  • ThedaCare Regional Medical Center-Neenah, 130, 2nd Street, Neenah, Winnebago County, Wisconsin, 54956, United States

    STE. A107

    NEENAH, WI 549562883

    Phone: (920) 729-3332

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-04-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070403000031ICertified Registered Nurse Anesthetist (Crna)WITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30907)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628103777View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YOH
Pain Management, AnesthesiologyIL
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YWI

Reviews

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Frequently asked questions

What is the 10-digit NPI for JAMES P MANDERLE (MD)?
JAMES P MANDERLE (MD) — NPI 1013905769 — is the standard way to identify this listing.
Is JAMES P MANDERLE (MD) listed as active for patients and plans?
The listing shows JAMES P MANDERLE (MD) as active in the NPI system.
What is JAMES P MANDERLE (MD)'s specialty?
The listing groups JAMES P MANDERLE (MD) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What area does JAMES P MANDERLE (MD) serve?
JAMES P MANDERLE (MD)'s listing highlights Augusta, Georgia; more addresses can appear in NPPES.
Is the information about JAMES P MANDERLE (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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