Vic Padila Managuelod, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95003644 Issued in CA

Practice address

630 E Cypress Ave
Apt a
Burbank, CA 91501-3211

Phone

(818) 813-4208

NPI assigned

Feb 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vic.managuelod.p1@direct.lakeside.nextgenshare.com
• Direct secure messaging: harneetkaur.sawhneydds.p1@direct.jwch.nextgenshare.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.

• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment Care Compare group NPD
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment NPD
• Valley Community Healthcare

  • Voluntary or Charitable Agency
  • North Hollywood, CA
  • NPI 1588740989
  Medicare reassignment NPD
• Valley Presbyterian Emergency Medical Associates

  • Emergency Medicine Physician
  • Van Nuys, CA
  • NPI 1033133103
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles

  dba Lake Los Angeles Community Clinic

  • Clinic/Center
  • Palmdale, CA
  • NPI 1720090616
  NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1932249505
  NPD
• Valley Community Healthcare

  • Voluntary or Charitable Agency
  • North Hills, CA
  • NPI 1932501996
  NPD
• Personal Touch Hospice Care Inc

  • Community Based Hospice Care Agency
  • Encino, CA
  • NPI 1669078663
  NPD (past)

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

{
    "created_epoch": "1454716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454716800000",
    "number": "1619335544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E CYPRESS AVE",
            "address_2": "APT A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915013211",
            "telephone_number": "818-813-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E CYPRESS AVE",
            "address_2": "APT A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915013211",
            "telephone_number": "818-813-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAGUELOD",
        "first_name": "VIC",
        "middle_name": "PADILA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-06",
        "last_updated": "2016-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95003644",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95003644",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95003644",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003644",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95003644",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95003644",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce A Malek, PSYD
• Andrea Malki
• Abigail Maller, M.D.
• Manachian Physical Therapy and Wellness Apc (Motion Works Physical Therapy)
• Gary Manachian, PT
• Neha Manchandia, PHARMD
• Giselle Mancilla
• Laura Mancini
• Elizabeth Nicole Mandarino
• Araceli M Mandi, DDS

• Nurse Practitioner in Burbank, CA
• Providers in Burbank, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2016; 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.