Plaxedes T Mandibaya, APRN-FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN245629 Issued in GA

Practice address

3449 Allie Dr
Snellville, GA 30039-7105

Phone

(404) 748-3425

NPI assigned

Apr 29, 2021

Last updated

Apr 29, 2021By 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 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gregg Soifer MD LLCGroup PAC ID 6901044023, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Gregg Soifer, MD, LLC

  • Physical Medicine & Rehabilitation Physician
  • Cumming, GA
  • NPI 1669816724
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1750964680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 SPRING RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161779",
            "telephone_number": "404-748-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 ALLIE DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397105",
            "telephone_number": "404-748-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIBAYA",
        "first_name": "PLAXEDES",
        "middle_name": "T",
        "credential": "APRN-FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN245629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Ryan Mahoney, DO
• Kimberly Ann Mainer, MS, OTR/L, CLT-LANA
• Seble Makonnen, PHARM.D
• Cahveevah Malik, OTR/L
• Abhijith Dev Mally, M.D.
• Sheetal Niranjan Mangalat, MD
• Shannon Allen Manley
• Peter Chun-Chung Mann, M.D.
• Ameleo D Manuel, M.A. LPC
• Marcy Inpatient Services LLC

• Nurse Practitioner in Snellville, GA
• Providers in Snellville, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.