Jose Fernando Mandujano, M.D.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

K3320 Issued in TX

Practice address

8501 Wade Blvd
BLDG. X, Suite 1020
Frisco, TX 75034-5894

Phone

(972) 668-5864

Fax

(972) 668-5825

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmandujano18339@direct.childrens.com

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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment NPD
• Texas Health Care, P.L.L.C.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1073679437
  NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352
  NPD
• Pediatric Pulmonary Assoc. of N. Texas

  • Specialist
  • Frisco, TX
  • NPI 1417095415
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1508817206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 WADE BLVD",
            "address_2": "BLDG. X, SUITE 1020",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345894",
            "telephone_number": "972-668-5864",
            "fax_number": "972-668-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 WADE BLVD",
            "address_2": "BLDG. X, SUITE 1020",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345894",
            "telephone_number": "972-668-5864",
            "fax_number": "972-668-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDUJANO",
        "first_name": "JOSE",
        "middle_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "TX",
            "license": "K3320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081278601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelmith Mamo, PMHNP
• Kshitij Manchanda, MD
• Fabrizio Mancini, DC
• Wahaj Mandavia, BCBA
• Josephine Mandeya, NP
• Baneen Fatima Manekia, RN, MSN, AGACNP-BC
• Rene Anthony Maney
• Caroline Elise Manfredi, OTR/L
• Caleb Mangum
• Katherine Belle Mankin

• Pediatric Pulmonology Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Pediatric Pulmonology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.