Lacey Manzanares

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

308 W 6TH St Ste 101
Corona, CA 92882-3349

Phone

(951) 737-0910

NPI assigned

Jul 27, 2021

Last updated

Jul 15, 2023By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lacey.manzanares.p1@direct.cvma.nextgenshare.com

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.

• Citrus Valley Medical Associates, Inc.

  dba Circle City Medical Group

  • Family Medicine Physician
  • Norco, CA
  • NPI 1306033709
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1689606196
  NPD

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689379200000",
    "number": "1669145553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5089",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928608003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W 6TH ST STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823349",
            "telephone_number": "951-737-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANARES",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2023-07-15",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meagan Kaye Mann
• Sandeep Kaur Mann, RDHAP
• Spiro Eddie Mansour
• Ahmad M. Mansury, M.D.
• Lyla Manumaleuna
• Cynthia M Manzo
• Aneela Manzoor, FNP
• Eustina Maoud, OD
• Calvin Marantz, M.D.
• Oana Anca Marc

• Medical Physician Assistant in Corona, CA
• Providers in Corona, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2023; 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.