Kimberly Mangla, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

275796 Issued in NY

Practice address

710 W 168TH St
12TH Floor
New York, NY 10032-3726

Phone

(212) 305-9758

NPI assigned

Apr 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Icahn School of Medicine at Mount Sinai

  dba Psychiatry Department of Mount Sinai

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • New York, NY
  • NPI 1033482518
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba OB/GYN Department of Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  Medicare reassignment
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Rivia Medical PLLC

  dba RIVIA Mind

  • Nutritionist
  • New York, NY
  • NPI 1871280818
  NPD

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1023309853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE",
            "address_2": "RM 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "212-203-1773",
            "fax_number": "646-665-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "address_2": "12TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-305-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGLA",
        "first_name": "KIMBERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "275796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Victor Manghisi, M.D
• Brianna Manginelli
• Michele Lynn Mangini-Vendel, N.P.
• Debra Mangino, MD
• Matthew Mangione, PHARMD
• Mahima Mangla
• Kara Manglani, CNM
• Anil Kumar Manglaram
• Mary Grace Mangle, NP
• Bernadita A Manglona

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.