Individual provider Active NPI

Ronaldo Cruz Mamaril, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1013301266
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
347604 Issued in NC
Practice address
1225 Harding PL
Ste 5100
Charlotte, NC 28204-2826
Phone
(704) 355-8850
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 347604 NC Primary

Addresses

Primary practice location

1225 Harding PL
Ste 5100
Charlotte, NC 28204-2826

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

16455 Statesville Rd
Ste 200
Huntersville, NC 28078-7135
Phone (704) 801-3011

Other practice location 2

101 E W T Harris Blvd
Ste 5401
Charlotte, NC 28262-3485
Phone (704) 863-1400

Other practice location 3

10650 Park Rd
Ste 480
Charlotte, NC 28210-8538
Phone (704) 667-0520

Other practice location 4

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963
Phone (704) 355-4593

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rmamaril982836@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211001000842 CA Practitioner - Nurse Practitioner 7012315211 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bay Gastroenterology Medical GroupGroup PAC ID 4183651375, 12 clinicians

Practice addresses (Care Compare)

23456 Hawthorne Blvd
Suite 300
Torrance, CA 90505-4716
Phone (310) 539-2055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 18, 2022 Accepting new patients
South Bay Gastroenterology Medical Group CurrentSince Oct 16, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 1, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 1, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 1, 2022 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 1, 2022 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Feb 27, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 18, 2022 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Nurse Practitioner CurrentSince Feb 27, 2023 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

19066 Magnolia St
Huntington Beach, CA 92646
Phone (714) 378-2225

10670 Wexford St
San Diego, CA 92131
Phone (858) 621-4010

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

23456 Hawthorne Blvd
Ste 300
Torrance, CA 90505
Phone (310) 316-6190

23451 Madison St
Ste 290
Torrance, CA 90505
Phone (310) 375-1246

100 N 6th St
Ste 900A
Minneapolis, MN 55403

101 E Wt Harris Blvd
Ste 5401
Charlotte, NC 28262
Phone (704) 863-1400

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204
Phone (704) 355-1813

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1225 Harding Pl
Ste 5100
Charlotte, NC 28204
Phone (704) 355-8850

10650 Park Rd
Ste 480
Charlotte, NC 28210
Phone (704) 355-1813

16455 Statesville Rd
Ste 200
Huntersville, NC 28078
Phone (704) 302-8600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rmamaril982836@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1013301266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HARDING PL",
            "address_2": "STE 5100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042826",
            "telephone_number": "704-355-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "704-801-3011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 5401",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-1400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 480",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-0520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-4593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMARIL",
        "first_name": "RONALDO",
        "middle_name": "CRUZ",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "347604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmamaril982836@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1225 Harding Pl",
            "address_2": "Ste 5100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.