Manuel Mandac

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

7432 Issued in CT

Practice address

25 Hidden Pines Cir
Meriden, CT 06451-2212

Phone

(203) 599-8207

NPI assigned

Feb 2, 2018

Last updated

Feb 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medi-NP, LLC

  • Family Nurse Practitioner
  • Meriden, CT
  • NPI 1629447727
  Medicare reassignment NPD

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1881193043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HIDDEN PINES CIR",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512212",
            "telephone_number": "203-599-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HIDDEN PINES CIR",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512212",
            "telephone_number": "203-599-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAC",
        "first_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "7432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rahul Magavi, MD
• Jaclyn Maier, COTA
• Kate E Maldonado, LPC
• David Malitsky, PHARMD
• Alison Diane Malone, LICSW
• Garrett Michael Manthey, PA-C
• Carol Marcantonio
• Frances M Marcantonio
• Lisa Marie Marcello, MS
• Ronald Maringola Jr., D.C.

• Gerontology Nurse Practitioner in Meriden, CT
• Providers in Meriden, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.