Susan T. Manabo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

285624-11204 Issued in CA

Practice address

26455 Marsala Way
Mission Viejo, CA 92692-3264

Phone

(949) 348-0476

Fax

(213) 484-9939

NPI assigned

Jul 13, 2006

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

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEAHDD/Endpoint/AEAHDD

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.

• PMD Wellness Center Inc

  • Multi-Specialty Clinic/Center
  • Long Beach, CA
  • NPI 1801505730
  NPD
• PMD Wellness Center Inc.

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1104485887
  NPD
• Ontario Family Medical Center Inc

  • Family Medicine Physician
  • Ontario, CA
  • NPI 1447561162
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1063437754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573602",
            "telephone_number": "949-348-0476",
            "fax_number": "213-484-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26455 MARSALA WAY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926923264",
            "telephone_number": "949-348-0476",
            "fax_number": "213-484-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANABO",
        "first_name": "SUSAN",
        "middle_name": "T.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "285624-11204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA RN LICENSE",
            "identifier": "285624",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susan.manabo.p1@direct.eisnerhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGenShare, Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1530 S Olive St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900153023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie Ann Malley, D.C.
• Sara Jane Malone, SLPA
• Shane Maloney
• Maloof Chiropractic Inc.
• Catherine L Maloof, D.C.
• Katherine Manasson, M.D.
• Lara A Manchik, P.A.C.
• Christine Manger
• Mary Jeanette Mannino, CRNA
• Anissa Mansoori, PA-C

• Family Nurse Practitioner in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.