Individual provider Active NPI

Luminita M Mann

  • Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1326338450
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
595716 Issued in CA
Practice address
100 E Valencia Mesa Dr
105
Fullerton, CA 92835-3813
Phone
(714) 446-5776
NPI assigned
Apr 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 595716 CA Primary

Addresses

Primary practice location

100 E Valencia Mesa Dr
105
Fullerton, CA 92835-3813

Mailing address

100 E Valencia Mesa Dr
105
Fullerton, CA 92835-3813
Phone (714) 446-5776

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
I20120608000220 CA Practitioner - Nurse Practitioner 4385808062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Phone (909) 860-1144

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

253 S Diamond Bar Blvd
Diamond Bar, CA 91765-1606
Phone (909) 860-1144

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19441CAMDPhysical Therapist
595716CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince May 5, 2012 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince May 5, 2012 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

Interoperability endpoints

  • Direct secure messaging: lmann1372996@oc.providencedirect.org

Organizations & group practices 4

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 2

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1326338450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR",
            "address_2": "105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353813",
            "telephone_number": "714-446-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR",
            "address_2": "105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353813",
            "telephone_number": "714-446-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "LUMINITA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "595716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.