Nathan Annop Mahanirananda, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11879 Issued in TX

Practice address

2813 W Southlake Blvd Ste 100
Southlake, TX 76092-6832

Phone

(817) 310-8783

NPI assigned

Mar 23, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Aaron C Eubanks MD PA

  • Orthopaedic Surgery Physician
  • Southlake, TX
  • NPI 1265977631
  NPD (past)

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1952805848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BRANCH RD",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077551026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 W SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926832",
            "telephone_number": "817-310-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHANIRANANDA",
        "first_name": "NATHAN",
        "middle_name": "ANNOP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginamar Magalhaes, PT, DPT
• Ann Marie Maggio, D.D.S.
• Magnolia Anesthesia Management LLC
• Magnolia Medspa Holdings PLLC
• Chelsea Maguire
• Asra Mahmood
• James J Mahoney, D.O
• Andrei Malacapay, DPT
• Mazyar Malakouti, M.D.
• Sophia Malani, OD

• Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Physician Assistant in Texas

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