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Deactivated NPI 1508810359 Deactivated / Inactive NPI Male Practitioner

Dr. Anil Mandal , MD

Internal Medicine - Nephrology • St Augustine, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Anil Mandal has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 19, 2006
NPI Deactivation Date September 20, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Anil Mandal, MD was a registered Internal Medicine - Nephrology practicing in St Augustine, FL. Throughout an active medical career spanning 12 years, Dr. Mandal provided care at the practice location at 665 STATE ROAD 207 until profile deactivation on 2018-09-20.

Practice Location & Contact Primary Location

Practice Address

665 State Road 207
Suite 102

St Augustine, FL 320845938

Telephone 9048248158
Fax 9048231284
Associated Practice Facility / Clinic
🏢 S S Marathe Md Pa Facility NPI 1275584492

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine - Nephrology in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 36.2 Yrs
State Avg: 28.0 Yrs
Regional Practice Density
7 Specialists

Practicing in St Augustine, FL (865 Statewide)

Telehealth Adoption Rate
28.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Internal Medicine - Nephrology Primary Specialty

NUCC Taxonomy Code: 207RN0300X

State License FL ME0074439

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Nivali Ravi , MD

Family Medicine

NPI 1114369055

Doctor of Medicine (M.D.)

Dr. Marina Rabkin , MD

Family Medicine

NPI 1366492951

Doctor of Medicine (M.D.)

Myragrace Golmayo , ARNP

Nurse Practitioner - Family

NPI 1548545361

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 20, 2018

Record deactivated on September 20, 2018

NPI Profile Active July 14, 2015

NPI status registered as active in NPPES database

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Updated Practice Location July 14, 2015

Registered at 665 STATE ROAD 207, SUITE 102, ST AUGUSTINE, FL 320845938 (Tel: 9048248158)

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Updated Business Mailing Address July 14, 2015

Registered at PO BOX 551308, JACKSONVILLE, FL 322551308 (Tel: 9044933333)

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Provider Name / Credentials Updated July 14, 2015

Recorded as ANIL MANDAL, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2015

Internal Medicine (License #ME0074439 in FL)

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Initial NPI Registration & Enumeration May 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508810359
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 19, 2006
Last Update: July 14, 2015
Deactivation Date: September 20, 2018

Mailing Address

Po Box 551308

Jacksonville, FL 322551308

Phone: 9044933333

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.