Individual provider Active NPI

Kiranvir Mangat

  • Pediatrics Physician
  • Los Gatos, CA
National Provider Identifier
1780986679
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A123401 Issued in CA
Practice address
15400 Los Gatos Blvd
Los Gatos, CA 95032-2502
Phone
(408) 730-6222
NPI assigned
Nov 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A123401 CA Primary

Addresses

Primary practice location

15400 Los Gatos Blvd
Los Gatos, CA 95032-2502

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140324001680 CA Practitioner - Pediatric Medicine 9739310392 Reassigns benefits to 3 organizations
I20150923002876 AZ Practitioner - Pediatric Medicine 9739310392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A123401CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Family Medicine CurrentSince Feb 26, 2024 Accepting new patients
Phoenix Children'S Hospital Pediatrics CurrentSince Aug 1, 2015 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2015 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Feb 1, 2014 Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Jul 21, 2016 Accepting new patients

Locations (25 of 28)

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

15400 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 523-3102

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

Interoperability endpoints

  • Direct secure messaging: kmangat196086@hisp.ehr.sutterhealth.org
  • Direct secure messaging: kmangat125843@santaclaravalley.direct-ci.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1290816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1780986679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "fax_number": "559-353-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322502",
            "telephone_number": "408-730-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAT",
        "first_name": "KIRANVIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-27",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A123401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.