Kseniya Aleksandrovna Mandic, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95003550 Issued in CA

Practice address

875 Blake Wilbur Dr
Palo Alto, CA 94304-2205

Phone

(650) 498-6000

NPI assigned

Oct 24, 2014

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

Other names 1

• Kseniya Aleksandrovna Levina Former name

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.

• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  NPD (past)

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1447655014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042205",
            "telephone_number": "650-498-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042205",
            "telephone_number": "650-498-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIC",
        "first_name": "KSENIYA",
        "middle_name": "ALEKSANDROVNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP141101",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KSENIYA",
            "last_name": "LEVINA",
            "middle_name": "ALEKSANDROVNA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hilda Man
• Janice Y Man, MD
• Nicole Man
• Nelliann Mancl
• Carmen Aguilar Mandac, NP
• Kimberly Mandujano
• Ann Lucille Manella
• Ellen Sidney Maness, MSW, LCSW
• Rachel Mangels, PHD, MS, LCGC
• Aditi Gupta Mani, MD

• Family Nurse Practitioner in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.