Individual provider Active NPI

Carmelita C Mangalindan, MD

  • Pediatrics Physician
  • Vineland, NJ
National Provider Identifier
1285612234
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06089300 Issued in NJ
Practice address
1505 W. Sherman Ave.
Vineland, NJ 08360-6912
Phone
(856) 641-4000
NPI assigned
Jan 9, 2006
Last updated
Oct 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA06089300 NJ Primary

Addresses

Primary practice location

1505 W. Sherman Ave.
Vineland, NJ 08360-6912

Mailing address

P.O. Box 191
Rockland, DE 19732-0191
Phone (302) 651-5985

Other identifiers 1

IdentifierTypeStateIssuer
7002408MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824001233 HI Practitioner - Pediatric Medicine 6002831047 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hilo Benioff Medical Center CurrentSince Jun 5, 2017 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Sep 29, 2017 Accepting new patients
North Hawaii Community Hospital, Inc CurrentSince Sep 29, 2017 Accepting new patients
Hilo Benioff Medical Center CurrentSince Jun 5, 2017 Accepting new patients
Queens North Hawaii Community Hospital Past Accepting new patients
Hilo Benioff Medical Center Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

Interoperability endpoints

  • Direct secure messaging: cmangalindan198649@direct.renown.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1285612234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W. SHERMAN AVE.",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606912",
            "telephone_number": "856-641-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGALINDAN",
        "first_name": "CARMELITA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06089300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002408",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.