Stephanie Elizabeth Manulkin, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95000298 Issued in CA

Practice address

1179 N McDowell Blvd
Petaluma, CA 94954-6559

Phone

(707) 559-7500

NPI assigned

Feb 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Stephanie Elizabeth Heron Former name

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Petaluma Health Center IncGroup PAC ID 9133180375, shared by 8 NPIs, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
• Accentcare Home Health of California, Inc Home health agency, San Ramon, CA, CCN 057517
• Mary'S Help Home Health Services, Inc Home health agency, Vallejo, CA, CCN 059143
• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: smanulkin741429@direct.ochin.org

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

• Accentcare Home Health of California, Inc.

  • Home Health Agency
  • San Ramon, CA
  • NPI 1972559961
  Care Compare affiliation
• Mary'S Help Home Health Services, Inc.

  • Home Health Agency
  • Vallejo, CA
  • NPI 1205929593
  Care Compare affiliation
• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1205865870
  Care Compare affiliation

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1508280595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 Northgate Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949032502",
            "country_code": "US",
            "telephone_number": "415-590-6150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANULKIN",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HERON",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mangrum Dental Corporation
• Yolanda Marye Mangrum, D.D.S.
• Emily Mann, LMFT
• Elmira Manoucheri, M.D.
• Sapoora Manshaii, MD
• Allison Marbella
• Julie Anne Marchione, RDH
• Alondra Mares
• Paul E. Margolis, LMFT
• Elpidio C Mariano, M.D.

• Family Nurse Practitioner in Petaluma, CA
• Providers in Petaluma, 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 Oct 23, 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.