Shahida Mangelsdorf, AGACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP7695 Issued in AZ

Practice address

500 W Thomas Rd Ste 500
Phoenix, AZ 85013-4220

Phone

(602) 406-4000

Fax

(602) 406-6498

NPI assigned

Jul 31, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shahida Khan Other name

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Sjhmc Physician Services

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  Medicare reassignment Care Compare group NPD
• St. Joseph'S Hospital and Medical Center

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  NPD

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1760868707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134220",
            "telephone_number": "602-406-4000",
            "fax_number": "602-406-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134220",
            "telephone_number": "602-406-4000",
            "fax_number": "602-406-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGELSDORF",
        "first_name": "SHAHIDA",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP7695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056526",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAHIDA",
            "last_name": "KHAN",
            "credential": "ACNPC-AG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alexis Maneth, RBT
• Tyler Maneth
• Anushriya Mangal, PA
• Anusha Mangalampalli, MD
• Naina Chaitanya Mangalmurti, MD
• Sidney Shane Mangelsdorf, AG-ACNP
• Marc N Manger, M.D., PLC
• Mary Mangiapane, RN
• Melissa Mangis, PHARMD
• Shilpi Seth Mangla, MD

• Acute Care Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.