Gina Dellacgua Mangin, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9104450 Issued in FL

Practice address

7335 W Sand Lake Rd
Suite 200
Orlando, FL 32819-5538

Phone

(407) 352-8553

Fax

(407) 351-8412

NPI assigned

May 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sand Lake Dermatology Center PAGroup PAC ID 6709853088, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.09 of 100Reported as individual

Quality

80.19

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

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.

• Sand Lake Dermatology Center, P.a.

  • Specialist
  • Orlando, FL
  • NPI 1558315234
  Medicare reassignment Care Compare group
• Aga Professional Services, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1063799120
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1861450553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7335 W SAND LAKE RD",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195538",
            "telephone_number": "407-352-8553",
            "fax_number": "407-351-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7335 W SAND LAKE RD",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195538",
            "telephone_number": "407-352-8553",
            "fax_number": "407-351-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIN",
        "first_name": "GINA",
        "middle_name": "DELLACGUA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9104450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0HS6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neal Mohen Mangalat, MD
• Jennifer Manganaro
• Nandanee Mangar, RBT
• Catherine Samson Manger, R.P.T.
• Lisa Marie Mangiarelli, DMD
• Sunanda Mangraj, MD
• Leyshka Mangual Rivera
• Viken A. Manguikian, O.D.
• Hailey Madison Mangum, APRN
• Lauren Colby Mangum, PHD, LAT, ATC

• Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.