NPIMap

Individual provider Active NPI

Rendell Esmane Manalo, D.O.

  • Nephrology Physician
  • Lancaster, CA
National Provider Identifier
1265610950
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A10559 Issued in CA
Practice address
1759 W Avenue J
Ste 101
Lancaster, CA 93534-2703
Phone
(661) 948-1388
Fax
(661) 948-1223
NPI assigned
Feb 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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 20A10559 CA Primary

Addresses

Primary practice location

1759 W Avenue J
Ste 101
Lancaster, CA 93534-2703

Mailing address

PO Box 2768
Lancaster, CA 93539-2768
Phone (661) 948-1388

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
I20130118000133 CA Practitioner - Internal MedicinePractitioner - Nephrology 0143489344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Antelope Valley Nephrology Medical Group IncGroup PAC ID 5395786206, 4 clinicians
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

1759 W Ave J
Suite 101
Lancaster, CA 93534-2703
Phone (661) 948-1388

212 S Richmond Rd
Ridgecrest, CA 93555-4434
Phone (661) 948-1388

335 E Ave I
Lancaster, CA 93535-1916
Phone (661) 471-4232

Hospital & facility affiliations

  • DaVita Palms Valley Dialysis Dialysis facility, Palmdale, CA, CCN 552845
  • DaVita Antelope Valley Dialysis Dialysis facility, Lancaster, CA, CCN 052521
  • SRS-Ridgecrest Dialysis Dialysis facility, Ridgecrest, CA, CCN 052789
  • DaVita Palmdale Regional Dialysis Dialysis facility, Palmdale, CA, CCN 052869
  • Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056
  • Palmdale Regional Medical Center Hospital, Palmdale, CA, CCN 050204
  • Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333
  • Mirage Post Acute Nursing home, Lancaster, CA, CCN 056039

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Mar 1, 2016 Accepting new patients
Antelope Valley Nephrology Medical Group, Inc. CurrentSince Jul 27, 2014 Accepting new patients
County of Los Angeles CurrentSince Mar 1, 2016 Accepting new patients
County of Los Angeles Current Accepting new patients
Lancaster Hospital Corporation Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1108 N Oleander Ave
Compton, CA 90222
Phone (310) 763-2244

123 W Manchester Blvd
Inglewood, CA 90301
Phone (310) 419-5325

1759 W Avenue J
#101
Lancaster, CA 93534
Phone (661) 948-1388

1600 W Avenue J
#1182
Lancaster, CA 93534
Phone (512) 901-3060

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

335 E Avenue I
Lancaster, CA 93535
Phone (661) 471-4000

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

212 S Richmond Rd
Ridgecrest, CA 93555
Phone (559) 432-5278

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rendell.manalo@direct.davitaphysiciansolutions.com

Organizations & group practices 5

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 7

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1265610950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2768",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935392768",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 W AVENUE J",
            "address_2": "STE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342703",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALO",
        "first_name": "RENDELL",
        "middle_name": "ESMANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A10559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.