Manda Beth Robinson, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18522 Issued in CA

Practice address

311 E Winston Street
Los Angeles Mission Community Clinic
Los Angeles, CA 90013

Phone

(213) 893-1960

Fax

(213) 893-1960

NPI assigned

Oct 11, 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

Other identifiers 2

Other names 1

• Miss Manda Beth Teeter Former name

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

Physician Assistant

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: manda.robinson.1@28348.direct.athenahealth.com

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.

• Chaparral Medical Group, Inc.

  • Dermatology Physician
  • Rancho Cucamonga, CA
  • NPI 1093777666
  Medicare reassignment
• Chaparral Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1477733624
  Medicare reassignment
• Wea Ca PC

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1699471482
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1972691384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N ALAMEDA AVE",
            "address_2": "B",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "91702",
            "telephone_number": "909-525-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E WINSTON STREET",
            "address_2": "LOS ANGELES MISSION COMMUNITY CLINIC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90013",
            "telephone_number": "213-893-1960",
            "fax_number": "213-893-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MANDA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70948F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EA970948F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDA",
            "last_name": "TEETER",
            "middle_name": "BETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Robinson
• Kennedy Robinson
• Kevin Robinson, PHYSICIAN ASSISTANT
• Kim Alexzandra Robinson, FNP
• Laurena P Robinson
• Mary Robinson, LMFT
• Maryum Hassan Robinson
• Melchizedek Abraham Robinson
• Mia L. Robinson, LVN
• Michael John Robinson, AMFT

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.