Individual provider Active NPI

Caroline M Ceniza Mancao, NP-C

  • Registered Nurse
  • Atlanta, GA
National Provider Identifier
1548555204
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN117790 Issued in GA
Practice address
5670 Peachtree Dunwoody Rd
Suite 880
Atlanta, GA 30342-1699
Phone
(404) 256-2525
Fax
(404) 845-4720
NPI assigned
Jun 10, 2011
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN117790 GA Primary

Addresses

Primary practice location

5670 Peachtree Dunwoody Rd
Suite 880
Atlanta, GA 30342-1699

Mailing address

5670 Peachtree Dunwoody Rd
Suite 880
Atlanta, GA 30342-1699
Phone (404) 256-2525

Other identifiers 1

IdentifierTypeStateIssuer
RN117790OtherGAGEORGIA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110808000409 GA Practitioner - Nurse Practitioner 4486823531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Practice addresses (Care Compare)

5670 Peachtree Dunwoody Rd
Suite 880
Atlanta, GA 30342-4789
Phone (404) 256-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
67.82
Promoting interoperability
77
Improvement activities
40
Cost
77.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN117790GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Cardiovascular Professional Services, LLC CurrentSince Jun 25, 2016 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 360
Alpharetta, GA 30005
Phone (770) 475-0077

1285 Upper Hembree Rd
Roswell, GA 30076
Phone (770) 343-8565

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5670 Peachtree Dunwoody Rd
Ste 880
Sandy Springs, GA 30342

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1548555204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 880",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421699",
            "telephone_number": "404-256-2525",
            "fax_number": "404-845-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 880",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421699",
            "telephone_number": "404-256-2525",
            "fax_number": "404-845-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCAO",
        "first_name": "CAROLINE",
        "middle_name": "M CENIZA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN117790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "RN117790",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.