Individual provider Active NPI

Mark Jayson Manuel, FNP-C

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1487454120
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95034369 Issued in CA
Practice address
5901 W Olympic Blvd Ste 505
Los Angeles, CA 90036-4670
Phone
(323) 930-2324
NPI assigned
Mar 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95034369 CA Primary
Registered Nurse 163W00000X 95211746 CA

Addresses

Primary practice location

5901 W Olympic Blvd Ste 505
Los Angeles, CA 90036-4670

Mailing address

5901 W Olympic Blvd Ste 505
Los Angeles, CA 90036-4670
Phone (323) 930-2324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95211746CAMDRegistered Nurse
95034369CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nassir Medical Corporation CurrentSince Dec 14, 2025 Accepting new patients

Locations

5901 W Olympic Blvd
Ste 505
Los Angeles, CA 90036
Phone (323) 930-2324

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1487454120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD STE 505",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364670",
            "telephone_number": "323-930-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD STE 505",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364670",
            "telephone_number": "323-930-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "MARK JAYSON",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95034369",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95211746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; 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.