Individual provider Active NPI

Christina Luella Manildi, P.A.

  • Physician Assistant
  • Santa Cruz, CA
National Provider Identifier
1316126436
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17668 Issued in CA
Practice address
1667 Dominican Way
Suite 134
Santa Cruz, CA 95065-1518
Phone
(831) 475-8834
Fax
(831) 475-1014
NPI assigned
Oct 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17668 CA Primary
Medical Physician Assistant 363AM0700X PA17668 CA

Addresses

Primary practice location

1667 Dominican Way
Suite 134
Santa Cruz, CA 95065-1518

Mailing address

3160 Folsom Blvd
Sacramento, CA 95816-5219
Phone (916) 733-5701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080110000258 CA Practitioner - Physician Assistant 1153401583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

160 Green Valley Rd
Suite 201
Freedom, CA 95019-3160
Phone (831) 458-5865

2025 Soquel Ave
Santa Cruez, CA 95062-1323
Phone (831) 423-4111

550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17668CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Dec 3, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Dec 3, 2013 Accepting new patients
Dignity Health Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

290 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 598-3160

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111

1667 Dominican Way
Ste 134
Santa Cruz, CA 95065
Phone (831) 475-8834

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

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.

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1316126436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165219",
            "telephone_number": "916-733-5701",
            "fax_number": "916-859-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 DOMINICAN WAY",
            "address_2": "SUITE 134",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651518",
            "telephone_number": "831-475-8834",
            "fax_number": "831-475-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANILDI",
        "first_name": "CHRISTINA",
        "middle_name": "LUELLA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17668",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.