Individual provider Active NPI

Tricia Manalastas, P.A.

  • Surgical Physician Assistant
  • Long Beach, CA
National Provider Identifier
1487769386
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA15922 Issued in CA
Practice address
2888 Long Beach Blvd.
Suite 180
Long Beach, CA 90807
Phone
(562) 595-5424
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA15922 CA Primary

Addresses

Primary practice location

2888 Long Beach Blvd.
Suite 180
Long Beach, CA 90807

Mailing address

23560 Crenshaw Blvd.
Suite 102
Torrance, CA 90505-1530
Phone (310) 784-2355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000488 CA Practitioner - Physician Assistant 8527026566 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

23560 Crenshaw Blvd
Torrance, CA 90505-5233

514 N Prospect Ave
FL 4
Redondo Beach, CA 90277-3040
Phone (310) 750-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Cities Orthopedics & Sports Medicine CurrentSince Apr 11, 2015 Accepting new patients
Torrance Health Association Inc CurrentSince Apr 1, 2017 Accepting new patients
Orthopaedic and Extremity Specialists Medical Group Inc Past Accepting new patients

Locations

705 Pier Ave
#B
Hermosa Beach, CA 90254
Phone (310) 784-2355

400 S Sepulveda Blvd
Ste 200
Manhattan Beach, CA 90266
Phone (310) 546-3461

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

23560 Crenshaw Blvd
Ste 102
Torrance, CA 90505
Phone (310) 784-2355

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1487769386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23560 CRENSHAW BLVD.",
            "address_2": "SUITE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905051530",
            "telephone_number": "310-784-2355",
            "fax_number": "310-517-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 LONG BEACH BLVD.",
            "address_2": "SUITE 180",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90807",
            "telephone_number": "562-595-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALASTAS",
        "first_name": "TRICIA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA15922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.