KRISTOPHER M MANDARO (NPI# 1336400464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336400464 |
| Entity Type | Individual |
| Full Name | KRISTOPHER M MANDARO |
| Credential | IDC |
| Practice Address |
2001 Victor Wharf Access Rd Pearl City HI 96782-3400 |
| Practice Telephone | 7706543208 |
| Mailing Telephone | 7706543208 |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
2001 VICTOR WHARF ACCESS RD |
| City | PEARL CITY |
| State | HI |
| Zip Code | 96782-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801858980 | Chris Spalding | Physical Therapy Assistant | 2001 Victor Wharf Access Rd, Nswg-3 Sports Medicine, Pearl City, HI 96782-3400 | 2006-04-04 |
| 1942710348 | Joshua Matthew Godsey | Military Health Care Provider | 2001 Victor Wharf Access Rd, Pearl City, HI 96782-3400 | 2017-10-11 |
| 1730524257 | Michael Sampson Duff | Military Health Care Provider | 2001 Victor Wharf Access Rd, Bldg 995, Pearl City Peninsula, Pearl City, HI 96782-3400 | 2013-05-10 |
| 1942552591 | Enrique Martino | Military Health Care Provider | 2001 Victor Wharf Access Rd, Building 987, Pearl City, HI 96782-3400 | 2012-10-05 |
| 1750648655 | Aaron Ricciarelli | Military Health Care Provider | 2001 Victor Wharf Access Rd, Pearl City, HI 96782-3400 | 2012-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801445663 | Benjamin Jacob Gomez | Clinic/Center | 2001 Victor Wharf, Pearl City, HI 96782 | 2019-09-05 |
| 1457824252 | Mary Jane P Harris | Nurse Practitioner | 98-1238 Kaahumanu St # 403, Pearl City, HI 96782 | 2019-01-04 |
| 1285141283 | Al's Vinyl Repair Inc. | Hearing Aid Equipment | 98-450 Kamehameha Hwy, #4, Pearl City, HI 96782 | 2017-12-29 |
| 1730601527 | North Shore Prosthetics and Orthotics Inc. | Prosthetic/Orthotic Supplier | 719 Kamehameha Hwy Ste B100, Pearl City, HI 96782 | 2017-07-12 |
| 1396158556 | Tian W He | Dentist | 850 Kamehameha Hwy #215, Pearl City, HI 96782 | 2014-06-05 |
| 1518307321 | Queens Medical Center | General Acute Care Hospital | 1348 Hoohui Street, Pearl City, HI 96782 | 2013-06-26 |
| 1437451903 | Ashley Cerzo Rivera | Nurse Practitioner | 1790 Paailuna Way, Pearl City, HI 96782 | 2010-12-03 |
| 1972684934 | Zaada Hailley | Marriage & Family Therapist | 1151 Waimano Home Rd, Pearl City, HI 96782 | 2006-10-18 |
| 1699876979 | Myron E Kawakami | Dentist | 98-1238 Ka'ahumanu St, #305, Pearl City, HI 96782 | 2006-09-26 |
| 1144328170 | Qsi Inc | Pharmacy | 98 1264 Kaahumanu St, Pearl City, HI 96782 | 2006-09-21 |
| Find all providers in zip 96782 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194028514 | Stephen Robert Way | Military Health Care Provider | 2001 Victor Warf Access Rd, Pearl City, HI 96782-3356 | 2010-12-07 |
| 1902108640 | Joshua Seth Nudelman | Military Health Care Provider | 2001 Victor Wharf Access Rd Bldg 987, Pearl City, HI 96782-3400 | 2010-12-01 |
| 1851626345 | Robert Andrew Kirk | Military Health Care Provider | 2001 Victor Wharf Access Road, Seal Delivery Vehicle Team One, Pearl City, HI 96782-3356 | 2009-10-16 |
| 1942710348 | Joshua Matthew Godsey | Military Health Care Provider | 2001 Victor Wharf Access Rd, Pearl City, HI 96782-3400 | 2017-10-11 |
| 1730524257 | Michael Sampson Duff | Military Health Care Provider | 2001 Victor Wharf Access Rd, Bldg 995, Pearl City Peninsula, Pearl City, HI 96782-3400 | 2013-05-10 |
| 1942552591 | Enrique Martino | Military Health Care Provider | 2001 Victor Wharf Access Rd, Building 987, Pearl City, HI 96782-3400 | 2012-10-05 |
| 1750648655 | Aaron Ricciarelli | Military Health Care Provider | 2001 Victor Wharf Access Rd, Pearl City, HI 96782-3400 | 2012-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205441888 | William Andrew Fitzpatrick | Military Health Care Provider | Bldg 6905, Mcbh, HI 96734 | 2020-09-10 |
| 1215549670 | Joseph Frabotta | Military Health Care Provider | 6894r Mokapu Rd, Kailua, HI 96734 | 2020-08-18 |
| 1508484882 | David Jason Brown | Military Health Care Provider | 6255 Kaawa St, Kailua, HI 96734-4984 | 2020-07-13 |
| 1134759715 | David Maldonado Santiago | Military Health Care Provider | 590 Moffet St, Jbphh, HI 96853-5168 | 2020-01-22 |
| 1003325366 | Justin Hesse | Military Health Care Provider | Building 17 Bishop Point, Pearl Harbor, HI 96860 | 2017-09-29 |
| 1649796244 | Joshua I White | Military Health Care Provider | Bldg 4078 Harris Rd., Mcbh Kaneohe Bay, HI 96863 | 2017-08-16 |
| 1104290519 | Carlton Jacob Maughan | Military Health Care Provider | Bldg 17 Bishops Point, Pearl Harbor, HI 96860 | 2015-11-23 |
| 1811363120 | Timothy Layton | Military Health Care Provider | 1016 Ulupau Loop, Kailua, HI 96734-4772 | 2015-08-20 |
| 1700263001 | Daniel Joseph Engelhardt | Military Health Care Provider | 5435 Kilmer Ln, Honolulu, HI 96818-3467 | 2015-05-06 |
| 1316350168 | Bryan Goodman | Military Health Care Provider | Bldg #1058, Mcbh Kaneohe Bay, HI 96863 | 2014-06-10 |
| Find all providers with the same taxonomy | ||||
| City | PEARL CITY |
| Zip Code | 96782 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.