Maria Hannah Tiangha Mandecote

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021998 Issued in CA

Practice address

3081 Teagarden St
San Leandro, CA 94577-5720

Phone

(510) 347-4620

NPI assigned

Aug 29, 2022

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Davis Street Community Center IncorporatedGroup PAC ID 6800956079, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9743/brand/1/csg/1/fhir/r4

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.

• The Davis Street Community Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • San Leandro, CA
  • NPI 1215358924
  Medicare reassignment Care Compare group NPD
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1669192969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 46TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3081 TEAGARDEN ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775720",
            "telephone_number": "510-347-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDECOTE",
        "first_name": "MARIA",
        "middle_name": "HANNAH TIANGHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Malone
• Jared Maloney
• Ronald David Maloney, MASTERS OF SOCIAL WE
• Brianna Roxane Maltez
• Alicia Lazam Manalomanuel, RRT RCP
• Ethel Lee Mandelbaum, OCCUPATIONAL THERAPI
• Kimberly Renee Mangarin, LCSW
• Manibog Chiropractic Center Inc
• Maria Manibog, DC
• Rogelia Castro Maniego

• Family Nurse Practitioner in San Leandro, CA
• Providers in San Leandro, 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 Aug 29, 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.
• 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.