Michael J Mangiaracina, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA892 Issued in NV

Practice address

9550 S Eastern Ave Ste 253
Las Vegas, NV 89123-8042

Phone

(888) 803-3370

NPI assigned

Sep 22, 2006

Last updated

Nov 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tahoe Forest Hospital DistrictGroup PAC ID 0446161335, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Incline Village Community Hospital Hospital, Incline Village, NV, CCN 291301
• Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epic-fhir.mercy.net/PRDFHIRAOK2/TAO/api/FHIR/R4/

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.

• Tahoe Forest Hospital District

  dba Tahoe Forest MultiSpecialty Clinics

  • Multi-Specialty Clinic/Center
  • Truckee, CA
  • NPI 1750412300
  Medicare reassignment Care Compare group
• Tahoe Forest Hospital District

  dba Incline Village Community Hospital

  • Critical Access Hospital
  • Incline Village, NV
  • NPI 1801957667
  Medicare reassignment NPD
• Carbon Health Alpha Medical Group of Florida PA

  • Urgent Care Clinic/Center
  • Reno, NV
  • NPI 1467108969
  Medicare reassignment
• Reno Emergency Physicians Association, PLLC

  • Emergency Medicine Physician
  • Reno, NV
  • NPI 1831299668
  Medicare reassignment
• Saint Mary's Medical Group Inc

  dba Saint Mary's Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Reno, NV
  • NPI 1447635578
  NPD
• Tahoe Forest Hospital District

  • Family Medicine Physician
  • Truckee, CA
  • NPI 1063068930
  NPD
• Tahoe Forest Hospital District

  • Rural Health Clinic/Center
  • Truckee, CA
  • NPI 1760038772
  NPD

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

• Tahoe Forest Hospital District

  dba Incline Village Community Hospital

  • Critical Access Hospital
  • Incline Village, NV
  • NPI 1801957667
  Care Compare affiliation
• Tahoe Forest Hospital District

  dba Tahoe Forest Hospital

  • Critical Access Hospital
  • Truckee, CA
  • NPI 1538265780
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1386744126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 S EASTERN AVE STE 253",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891238042",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 S EASTERN AVE STE 253",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891238042",
            "telephone_number": "888-803-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10956 Donner Pass Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961614860",
            "country_code": "US",
            "telephone_number": "530-550-6748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGIARACINA",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505588",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip Mangar, LPN
• Tylor Mangayayam
• Jaqueline Mange
• Alexandra Mangene
• Flordeliza Mangente
• Joel Estocado Mangibin
• Gina Mangin
• Dee Ann Mangino-Sullivan
• Kristina Manginsay
• Alyssa Winona Mangio

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.

Verify at the official NPI Registry.