Soraya Mangondato

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP 16166 Issued in CA

Practice address

1333 Bush St
San Francisco, CA 94109-5611

Phone

(415) 292-8888

NPI assigned

Dec 12, 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

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thomas B Hazlehurst M DGroup PAC ID 7315980414, 3 clinicians

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Thomas B Hazlehurst, M.D.

  • Internal Medicine Physician
  • Daly City, CA
  • NPI 1205846789
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881755072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 PICCADILLY PL",
            "address_2": "6",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 BUSH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095611",
            "telephone_number": "415-292-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGONDATO",
        "first_name": "SORAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP 16166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Joseph Mangini, MA COUNSELING PSYCH
• Sowmya A Mangipudi
• Norman Vincent Diaz Manglona
• Daniel Clayton Mango
• Jehan Rigor Mangondato, PT
• Christian-Lowell Mangonon, LVN
• Yvette Sylvia Mangual McWilliams, RADT
• Scion Canlas Mangubat, NP-C
• Andrew Mangum, O.D.
• Kevin Dale Mangum, MD

• Gerontology Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.