Tracy D Mandryk, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

388425 Issued in CA

Practice address

1901 Outlet Center Dr
Suite 230
Oxnard, CA 93036-0663

Phone

(805) 983-6233

NPI assigned

Apr 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Coastal Endovascular Center Inc

  • Vascular Surgery Physician
  • Oxnard, CA
  • NPI 1598054645
  NPD (past)

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1356667059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 WATERBURY LN",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013841",
            "telephone_number": "805-766-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 OUTLET CENTER DR",
            "address_2": "SUITE 230",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360663",
            "telephone_number": "805-983-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRYK",
        "first_name": "TRACY",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "388425",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "388425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Maldonado
• Lily Ann Mallare, M.D.
• Crystal Michelle Malta
• Jazelle Ann Manalo
• Perla A Mancillas
• Manglani Inc
• Umesh Rajkumar Manglani, M.PHARM
• Manoj Khatore MD a Professional Corporation
• Sondra Manor, DDS
• Nellie Manoukian, DDS

• Acute Care Nurse Practitioner in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.