Aishah Mandeel, NURSE PRACTITIONER

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95011055 Issued in CA

Practice address

14971 Holt Ave
Tustin, CA 92780-3406

Phone

(949) 356-7676

NPI assigned

Feb 1, 2019

Last updated

Feb 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Pinnacle Medical Group, Inc

  dba Optum

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1376876912
  Medicare reassignment NPD
• Pinnacle Medical Group, Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1043255763
  NPD
• PM Pediatrics of California Professional Corporation

  • Urgent Care Clinic/Center
  • Los Angeles, CA
  • NPI 1578030359
  NPD (past)
• United Family Care

  • Internal Medicine Physician
  • Fontana, CA
  • NPI 1629027255
  NPD (past)

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1063977270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13446 WARREN PL",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14971 HOLT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803406",
            "telephone_number": "949-356-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEEL",
        "first_name": "AISHAH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95011055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
            "identifier": "95011055",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madelyn Rose Malisani
• Jeffrey Wayne Mallock, DC
• Michelle Nicole Malloy, M.S., MFT
• Matthew Jacob Sinlao Manalo, PTA
• Dimple Manchandia
• Michelle Manzer
• Abigail Joy Maqsood
• Evelyn Mares
• Marilou D. Elido, DMD, Inc.
• Esperanza Marin

• Pediatric Nurse Practitioner in Tustin, CA
• Providers in Tustin, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.