Active NPI
Kristin K Mancuso, PA
- Emergency Clinical Nurse Specialist
- Oakland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Clinical Nurse Specialist
- License
- PA16054
- Practice address
- 1411 E 31St St
Oakland, CA 94602-1018 - Phone
- (209) 342-2300
- Fax
- (209) 524-4240
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Clinical Nurse Specialist | 364SE0003X | PA16054 | CA | Primary |
Addresses
Primary practice location
1411 E 31St St
Oakland, CA 94602-1018
Mailing address
4301 Northstar Way
Modesto, CA 95356-9262
Phone (209) 342-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPA160540 | Medicaid | CA |
Other names 1
- Kristin K Maldonado
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.17 of 100
- Quality
- 86.93
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA16054 | CA | MD | Emergency Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alameda Health System | Current | Accepting new patients | |
| Alameda Health System | Current | Accepting new patients |
Locations
664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700
6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600
1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323
7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768
6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700
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.
-
- Federally Qualified Health Center (FQHC)
- Newark, CA
- NPI 1497956288
-
- Surgery Physician
- Oakland, CA
- NPI 1740332931
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306824669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 NORTHSTAR WAY",
"city": "MODESTO",
"state": "CA",
"postal_code": "953569262",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 E 31ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021018",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCUSO",
"first_name": "KRISTIN",
"middle_name": "K",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "364SE0003X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Emergency",
"state": "CA",
"license": "PA16054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OPA160540",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTIN",
"last_name": "MALDONADO",
"middle_name": "K",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.