Ajay Manchandia, MD

Primary specialty

Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X

License

A120510 Issued in CA

Practice address

1120 W la Veta Ave Ste 100
Orange, CA 92868-4215

Phone

(714) 509-4490

NPI assigned

Jul 25, 2008

Last updated

Dec 22, 2023By the provider in NPPES

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

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Children's Hospital of Orange County

  dba CHOC Children's Specialists

  • Pediatrics Physician
  • Orange, CA
  • NPI 1275975104

  Ophthalmology

  Medicare reassignment NPD
• Eye Physicians of Long Beach a Medical Group Inc.

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1235231598
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Long Beach Memorial Medical

  dba Miller Children's Hospital

  • Children's Hospital
  • Long Beach, CA
  • NPI 1477596583
  NPD (past)
• Pediatric Subspecialty Faculty, Inc.

  • Pediatrics Physician
  • Orange, CA
  • NPI 1790850279
  NPD (past)
• Sidney Jay Weiss, M.D. Inc

  dba Saddleback Eye Medical Associates

  • Ophthalmology Physician
  • Mission Viejo, CA
  • NPI 1407873326
  NPD (past)
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1720243082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LONG BEACH BLVD STE 108",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072696",
            "telephone_number": "562-426-3925",
            "fax_number": "562-595-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W LA VETA AVE STE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684215",
            "telephone_number": "714-509-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Long Beach Blvd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908072696",
            "country_code": "US",
            "telephone_number": "562-426-3925",
            "fax_number": "562-595-7639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHANDIA",
        "first_name": "AJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A120510",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "CA",
            "license": "A120510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1205100",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark Daniel Mamlouk, M.D.
• Carol Man, MD
• Brian Manahan
• Ernesto Manahan
• Michael Christopher Manazer
• Manchester Surgical Pavillion
• Michelle Manchester
• Itzel Berenice Mancilla-Murillo, LCGC
• Brianna Alexis Mancilla
• Jennifer Wahida Mandhai, FNP

• Pediatric Ophthalmology and Strabismus Specialist Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatric Ophthalmology and Strabismus Specialist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.
• 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.