Active NPI
Kimberly Mae Mangubat, M.D.
- Pediatrics Physician
- Deptford, NJ
National Provider Identifier
1962835207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA09485100
- Practice address
- 849 Cooper St
Deptford, NJ 08096-2571 - Phone
- (856) 848-6346
- Fax
- (856) 848-5734
- NPI assigned
- Aug 9, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA09485100 | NJ | Primary |
Addresses
Primary practice location
849 Cooper St
Deptford, NJ 08096-2571
Mailing address
849 Cooper St
Deptford, NJ 08096-2571
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09485100 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare, LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kimberly.mangubat@advocaredoctors.eclinicaldirectplus.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1962835207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "849 COOPER ST",
"city": "DEPTFORD",
"state": "NJ",
"postal_code": "080962571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "849 COOPER ST",
"city": "DEPTFORD",
"state": "NJ",
"postal_code": "080962571",
"telephone_number": "856-848-6346",
"fax_number": "856-848-5734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUBAT",
"first_name": "KIMBERLY",
"middle_name": "MAE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-09",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA09485100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deptford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.