NPIMap

Individual provider Active NPI

Angelie Azuncion Manaloto Santos

  • Nephrology Physician
  • Las Vegas, NV
National Provider Identifier
1356838601
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MC-386 Issued in GU
Practice address
1294 S Jones Blvd
Las Vegas, NV 89146-1284
Phone
(240) 390-5676
NPI assigned
Apr 21, 2018
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 75115-20 WI
Nephrology Physician 207RN0300X MC-386 GU Primary
Nephrology Physician 207RN0300X 25503 NV

Addresses

Primary practice location

1294 S Jones Blvd
Las Vegas, NV 89146-1284

Mailing address

1294 S Jones Blvd
Las Vegas, NV 89146-1284
Phone (702) 877-1887

Other identifiers 2

IdentifierTypeStateIssuer
1356838601MedicaidWI
250030795MedicaidNV

Other names 1

  • Angelie Azuncion Mirasol Manaloto Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220624000450 WI Practitioner - NephrologyPractitioner - Hospitalist 9133463656 Reassigns benefits to 2 organizations
I20240508003263 NV Practitioner - Nephrology 9133463656 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology and Endocrine Associates IncGroup PAC ID 2961499322, shared by 2 NPIs, 64 clinicians

Practice addresses (Care Compare)

8775 Deer Springs Way
Las Vegas, NV 89149-0416
Phone (702) 877-1887

9280 W Sunset Rd
Las Vegas, NV 89148-4862
Phone (702) 877-1887

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25503NVMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Jun 13, 2022 Accepting new patients
Nephrology & Endocrine Associates Inc Nephrology CurrentSince May 1, 2024 Accepting new patients
Dean Health Systems, Inc Family Medicine CurrentSince Jun 13, 2022 Accepting new patients
Sauk Prairie Healthcare, Inc. Family Medicine CurrentSince Jun 23, 2023 Accepting new patients
Sauk Prairie Healthcare Inc CurrentSince Jun 23, 2023 Accepting new patients
Nephrology & Endocrine Associates Inc CurrentSince May 1, 2024 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 310
Henderson, NV 89074
Phone (702) 565-6565

500 S Rancho Dr
Ste 12
Las Vegas, NV 89106
Phone (702) 877-1877

8775 Deer Springs Way
Las Vegas, NV 89149
Phone (702) 395-2488

7326 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129

7326 W Cheyenne Ave
Ste 110
Las Vegas, NV 89129
Phone (702) 258-0078

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1877

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

Interoperability endpoints

  • Direct secure messaging: asantos39060@direct.davitaphysiciansolutions.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: angelie.santos.p35@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: angelie.santos.p208@direct.aac.nextgenshare.com

Organizations & group practices 8

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1356838601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461284",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461284",
            "telephone_number": "240-390-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ANGELIE AZUNCION",
        "middle_name": "MANALOTO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-21",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "75115-20",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GU",
            "license": "MC-386",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "25503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356838601",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250030795",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELIE AZUNCION",
            "last_name": "MANALOTO",
            "middle_name": "MIRASOL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.