Organization Active NPI

Gaytri Manek MD Inc

  • Nephrology Physician
  • Fountain Valley, CA
National Provider Identifier
1912352774
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
GAYTRI MANEK MD INC
Practice address
11180 Warner Ave
Ste 271
Fountain Valley, CA 92708-7501
Phone
(714) 435-0150
Fax
(714) 436-0126
NPI assigned
Apr 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Authorized official

Name
Gaytri Manek, MDNPI 1124298237
Title
Owner
Phone
(714) 435-0150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

11180 Warner Ave
Ste 271
Fountain Valley, CA 92708-7501

Mailing address

11180 Warner Ave
Ste 271
Fountain Valley, CA 92708-7501
Phone (714) 435-0150

Other identifiers 1

IdentifierTypeStateIssuer
GR0092700MedicaidCA

Other names 1

  • Gaytri Gandotra MD Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160707002527 CA Part B Supplier - Clinic/Group Practice 6002108271 Receives reassigned benefits from 2 practitioners
Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1912352774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "STE 271",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-435-0150",
            "fax_number": "714-436-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "STE 271",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-435-0150",
            "fax_number": "714-436-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYTRI MANEK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "MANEK",
        "authorized_official_first_name": "GAYTRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-435-0150",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gaytri Gandotra MD Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.