Individual provider Active NPI

Brandon Cole Manibog, FNP-C

  • Nurse Practitioner
  • Santa Clarita, CA
National Provider Identifier
1861161689
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95018275 Issued in CA
Practice address
26910 Sierra Hwy Ste D8
Santa Clarita, CA 91321-2262
Phone
(661) 388-5750
NPI assigned
Sep 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95018275 CA Primary

Addresses

Primary practice location

26910 Sierra Hwy Ste D8
Santa Clarita, CA 91321-2262

Mailing address

28576 Foothill Way
Santa Clarita, CA 91350-3290
Phone (928) 514-9131

Other practice location 1

41210 11th St W # 1447
Palmdale, CA 93551-1447
Phone (661) 947-7100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221207003098 CA Practitioner - Nurse Practitioner 9830568195 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians
Canyon Urgent CareGroup PAC ID 3779015714, 5 clinicians
Em Alliance California ApcGroup PAC ID 1951749894, 68 clinicians

Practice addresses (Care Compare)

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone (661) 200-2000

26910 Sierra Hwy
Suite D8
Santa Clarita, CA 91321-2262
Phone (661) 210-3240

38600 Medical Ctr Dr
Palmdale, CA 93551-4483
Phone (661) 382-5000

Hospital & facility affiliations

  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Primary Care CurrentSince Nov 18, 2025 Accepting new patients
Cep America - California CurrentSince Jun 15, 2023 Accepting new patients
Cep America-California CurrentSince Jun 15, 2023 Accepting new patients
Canyon Urgent Care CurrentSince Sep 10, 2024 Accepting new patients
Cep America - California Current Accepting new patients
Em Alliance California, Apc CurrentSince Apr 11, 2024 Accepting new patients
Smartclinic Inc PastSince Aug 1, 2026 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

26910 Sierra Hwy
Ste D8
Santa Clarita, CA 91321
Phone (661) 210-3240

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

L4421
Columbus, OH 43260

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1861161689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28576 FOOTHILL WAY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913503290",
            "telephone_number": "928-514-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26910 SIERRA HWY STE D8",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212262",
            "telephone_number": "661-388-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41210 11th St W # 1447",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935511447",
            "country_code": "US",
            "telephone_number": "661-947-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANIBOG",
        "first_name": "BRANDON",
        "middle_name": "COLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

Verify at the official NPI Registry.