NPIMap

Individual provider Active NPI

Gaytri Manek, MD

  • Nephrology Physician
  • Fountain Valley, CA
National Provider Identifier
1124298237
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A106569 Issued in CA
Practice address
11180 Warner Ave
Suite 271
Fountain Valley, CA 92708
Phone
(714) 435-0150
Fax
(714) 436-0126
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A106569 CA Primary

Addresses

Primary practice location

11180 Warner Ave
Suite 271
Fountain Valley, CA 92708

Mailing address

11180 Warner Ave
Suite 271
Fountain Valley, CA 92708
Phone (714) 435-0150

Other identifiers 1

IdentifierTypeStateIssuer
GR0092700MedicaidCA

Other names 1

  • Gaytri Gandotra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120927000588 CA Practitioner - NephrologyPractitioner - Internal Medicine 8527240191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gaytri Manek MD IncGroup PAC ID 6002108271, 2 clinicians

Practice addresses (Care Compare)

11180 Warner Ave
Suite 271
Fountain Valley, CA 92708-7516
Phone (714) 435-0150

Hospital & facility affiliations

  • Usrc Beach Dialysis Dialysis facility, Westminster, CA, CCN 752556
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678
  • Chapman Global Medical Center Hospital, Orange, CA, CCN 050745
  • Garden Grove Hospital & Medical Center Hospital, Garden Grove, CA, CCN 050230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106569CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chest and Critical Care Consultants Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Gaytri Manek MD Inc Nephrology CurrentSince Jul 1, 2016 Accepting new patients
Chest and Critical Care Consultants a Medical Group Internal Medicine Current Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Chapman Medical Center Inc Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 404
Anaheim, CA 92801
Phone (714) 772-1030

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

11180 Warner Ave
Ste 463
Fountain Vly, CA 92708
Phone (714) 241-9200

11180 Warner Ave
Ste 271
Fountain Vly, CA 92708
Phone (714) 435-0150

13522 Newport Ave
Ste 102
Tustin, CA 92780
Phone (714) 573-8200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 8

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1124298237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "SUITE 271",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-435-0150",
            "fax_number": "714-436-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "SUITE 271",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-435-0150",
            "fax_number": "714-436-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEK",
        "first_name": "GAYTRI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A106569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAYTRI",
            "last_name": "GANDOTRA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.