MILENA M ANDZELM (M.D., PH.D.) – Neurology with Special Qualifications in Child Neurology Physician, NPI 1073975579

MILENA M ANDZELM (M.D., PH.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in NEUROLOGY. They hold the professional credentials M.D., PH.D.. They hold a License No. 281732 (MA). The NPI Number for MILENA M ANDZELM (M.D., PH.D.) is 1073975579

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MILENA M ANDZELM (M.D., PH.D.)
NPI
1073975579
Phone
(617) 355-6000
Address
300 LONGWOOD AVE
Enumeration Date
23 March 2016
Last Update Date
3 May 2023

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
6173556000
Graduation Year
2016 (10 years ago)
PAC ID
7618333949
Group Practice PAC ID
5496744195
Professional Enrollment ID
I20230511002503
Address ID
MA021155724BO300XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,144 NEUROLOGY in MA

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Provider Addresses for MILENA M ANDZELM (M.D., PH.D.)

  • Children's Hospital Library, 300, Longwood Avenue, Roxbury, Boston, Suffolk County, Massachusetts, 02120, United States

    BOSTON, MA 021155724

    Phone: (617) 355-6000

    Mailing address matches the actual address.

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: 2023-05-11

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
I20230511002503INeurologyMATBD

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 02115)

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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: 5496744195View full group profile
NameSpecialtyState
-MA
Pediatric Medicine, NeurologyMA
N E U R O L O G YMA
N E U R O L O G YMA
Neurology, Pediatric MedicineMA
Neurology, Pediatric MedicineMA
N E U R O L O G YMO
N E U R O L O G YMA
N E U R O L O G YMA
-MA

Reviews

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Frequently asked questions

Can I use this page to confirm MILENA M ANDZELM (M.D., PH.D.)'s NPI?
Yes. MILENA M ANDZELM (M.D., PH.D.) is listed with NPI 1073975579 in the public NPI dataset.
Does the file indicate MILENA M ANDZELM (M.D., PH.D.) is practicing under active NPI?
Directory data currently reports MILENA M ANDZELM (M.D., PH.D.) as active.
What taxonomy line describes MILENA M ANDZELM (M.D., PH.D.)?
For research purposes, treat MILENA M ANDZELM (M.D., PH.D.) as Neurology with Special Qualifications in Child Neurology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is MILENA M ANDZELM (M.D., PH.D.) based?
MILENA M ANDZELM (M.D., PH.D.) is tied to Boston, Massachusetts in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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