Individual provider Active NPI

Mandana Miramadi, D.C.

  • Chiropractor
  • Orange, CA
National Provider Identifier
1881090843
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 33004 Issued in CA
Practice address
1122 E Lincoln Ave Ste B200
Orange, CA 92865-1918
Phone
(714) 602-7479
Fax
(714) 602-7408
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 33004 CA Primary

Addresses

Primary practice location

1122 E Lincoln Ave Ste B200
Orange, CA 92865-1918

Mailing address

PO Box 17633
Anaheim, CA 92817-7633
Phone (714) 602-7479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150128001346 CA Practitioner - Chiropractic 7810210465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 E Lincoln Ave
Suite B200
Orange, CA 92865-1918
Phone (714) 602-7479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 33004CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Goshtasbi Chiropractic Inc Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1881090843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17633",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928177633",
            "telephone_number": "714-602-7479",
            "fax_number": "714-602-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E LINCOLN AVE STE B200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651918",
            "telephone_number": "714-602-7479",
            "fax_number": "714-602-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAMADI",
        "first_name": "MANDANA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 33004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.