Individual provider Active NPI

Riza Manangan, NP

  • Registered Nurse
  • Baltimore, MD
National Provider Identifier
1194463067
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R200557 Issued in MD
Practice address
815 Eastern Blvd
Baltimore, MD 21221-3535
Phone
(410) 642-9172
Fax
(877) 635-7186
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R200557 MD Primary

Addresses

Primary practice location

815 Eastern Blvd
Baltimore, MD 21221-3535

Mailing address

4535 Ridge Rd
Baltimore, MD 21236-3825
Phone (443) 559-2892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R200557MDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Corazon-Panes Sanchez,LLC CurrentSince Nov 1, 2024 Accepting new patients
Corazon-Panes Sanchez,LLC PastSince May 29, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1194463067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 RIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212363825",
            "telephone_number": "443-559-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 EASTERN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212213535",
            "telephone_number": "410-642-9172",
            "fax_number": "877-635-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANANGAN",
        "first_name": "RIZA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R200557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.