NPIMap

Individual provider Active NPI

Angela J Manderfeld, MS, RD, CDE

  • Registered Dietitian
  • Anchorage, AK
National Provider Identifier
1275833469
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
AK133 Issued in AK
Practice address
4320 Diplomacy Dr.
Anchorage, AK 99508
Phone
(907) 729-1500
Fax
(907) 729-1508
NPI assigned
Oct 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X AK133 AK Primary

Addresses

Primary practice location

4320 Diplomacy Dr.
Anchorage, AK 99508

Mailing address

4315 Diplomacy Dr
Anc-Dia
Anchorage, AK 99508
Phone (907) 729-1128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050211000122 AK Practitioner - Registered Dietitian Or Nutrition Professional 9234181827 Reassigns benefits to 1 organization
I20110413000155 TX Practitioner - Registered Dietitian Or Nutrition Professional 9234181827 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Anchorage, AK 99516
Phone (907) 250-2531

Hospital & facility affiliations

  • Maniilaq Health Center Hospital, Kotzebue, AK, CCN 021310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AK133AKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Mar 6, 2012 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Feb 13, 2017 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Feb 13, 2017 Accepting new patients
Maniilaq Association Current Accepting new patients
Maniilaq Association CurrentSince Sep 17, 2019 Accepting new patients
Healthy Solutions With Angela LLC CurrentSince Sep 26, 2022 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

Interoperability endpoints

  • Direct secure messaging: angela.manderfeld.1@15989.direct.athenahealth.com

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 12

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": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1275833469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "address_2": "ANC-DIA",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-729-1128",
            "fax_number": "907-729-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR.",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-729-1500",
            "fax_number": "907-729-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDERFELD",
        "first_name": "ANGELA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "AK133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.