Constance J Mangiamele, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R1494411 Issued in MN

Practice address

190 Sailstar Dr. NW
Cass Lake, MN 56633

Phone

(218) 335-4500

NPI assigned

Jan 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Constance J Mangiamele Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1073979084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 MAPLE RIDGE CT NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566018020",
            "telephone_number": "218-766-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SAILSTAR DR. NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIAMELE",
        "first_name": "CONSTANCE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R149441-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1494411",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1494411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "MANGIAMELE",
            "middle_name": "J",
            "prefix": "MS.",
            "credential": "APRN FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Oluwasikemi A Lotsu, PHARM.D
• Loretta Jean Lynne, RN
• Birdena M Lyons, LPN
• Duane Malterud, DNP
• Jessica Rose Malterud, BSN, PHN, RN
• Rachel Marie Markham
• Roberta L Marsolek, RN
• Lindsey Renee Marvel, O.D.
• Alissa Massie, DPT
• Anoshirvan Mazhari, M.D.

• Family Nurse Practitioner in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.