Dr. Staci A Mandrola, MD
Internal Medicine, Hospice and Palliative Medicine in Louisville, KY. Individual provider (NPI-1).
Details
- NPI
- 1912129552
- Entity type
- Individual (NPI-1)
- Name
- Dr. Staci A Mandrola
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 3, 2007
- Last updated
- Jan 11, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RH0002X | Internal Medicine, Hospice and Palliative Medicine | 41139 | KY | Yes |
Practice location
7504 Westport RdLouisville, KY 40222-4108
Phone 502-693-2681 · Fax 502-456-9738
Mailing address
2500 Meadow RdLouisville, KY 40205-2220
Phone 502-456-9738
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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