Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mark Mangkhalakhili, PA-C

Individual provider Physician Assistant · NPI 1508517897

Mark Mangkhalakhili, PA-C is a Physician Assistant in Williamsville, New York. Qualified in 2023, 3 years ago. Practices with Brain and Spine Medical Services PLLC, a 56-clinician group and accepts Medicare assignment. Licensed in Massachusetts, New Hampshire and New York.

Years since qualifying
3
Licensed in
MA, NH, NY
In the registry since
2022
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

400 International Dr
Williamsville, NY 14221-5771
Phone: (716) 631-3555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 032617 (NY)
Physician Assistant Taxonomy 363A00000X · Licence PA9474 (MA)
Physician Assistant Taxonomy 363A00000X · Licence 2127 (NH)

Record details

NPI number1508517897
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 18, 2022
Last updated in NPPESFebruary 12, 2025
Certification dateFebruary 12, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Brain And Spine Medical Services Pllc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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