Miguel Santiago Gonzalez Mancera, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

PTL5076 Issued in CA

Practice address

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Phone

(310) 423-3277

NPI assigned

Jan 27, 2021

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191
• Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Niskayana, NY
  • NPI 1154973071

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1376577247
  Care Compare affiliation
• Albany Medical Center Hospital

  • Clinical Medical Laboratory
  • Albany, NY
  • NPI 1700204641

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • Radiology Clinic/Center
  • Albany, NY
  • NPI 1811448657

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1811917461
  Care Compare affiliation
• Glens Falls Hospital Inc

  • General Acute Care Hospital
  • Glens Falls, NY
  • NPI 1871606764
  Care Compare affiliation

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1952992463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WILSHIRE BLVD APT 328",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364693",
            "telephone_number": "786-757-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MANCERA",
        "first_name": "MIGUEL",
        "middle_name": "SANTIAGO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "PTL5076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beatrice Goldman, LCSW
• Hooman Golfeiz
• Rimma R Golub, NP
• Lyric Gomez
• Jun Gong
• Austin Gonzalez, MD
• Bernadette Beatrice Gonzalez, PA
• Jasmin Elizabeth Marie Gonzalez, RADT# 1460350322
• Nestor Gonzalez, MD
• Shannon Zoe Marie Gonzalez

• Anatomic Pathology & Clinical Pathology Physician in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.