Paul Andrew Mahnke, ACNPC-AG
Individual provider Active NPI Nurse Practitioner · Lake Havasu City, AZ
NPI 1982123618 · NPPES record last updated Sep 23, 2017
Key facts
- NPI
- 1982123618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP10571 (AZ)
- Practice address
- 2082 Mesquite Ave
Lake Havasu City, AZ 86403-6710 - Phone
- (928) 453-2727
- NPI assigned
- Sep 13, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lakeside Heart and Vascular Center PLLC
Practice addresses (Care Compare)
2082 Mesquite Ave
Suite 100a
Lake Havasu City, AZ 86403-6710
Phone (928) 453-2727
Hospital & facility affiliations
- La Paz Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.85 of 100
- Quality
- 60.31
- Promoting interoperability
- 93
- Improvement activities
- 40
- Cost
- 78.37
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171024002706 | AZ | Practitioner - Nurse Practitioner | 5991071656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP10571 | AZ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Paz Regional Hospital Inc | Current | Accepting new patients | |
| Lakeside Heart and Vascular Center PLLC | Current |
Accepting new patients |
Locations
2020 Silver Creek Rd
Bullhead City, AZ 86442
Phone (928) 754-1804
1753 Airway Ave
Ste A
Kingman, AZ 86409
Phone (520) 757-4359
2849 Maricopa Ave
Lake Havasu City, AZ 86406
2082 Mesquite Ave
Lake Havasu City, AZ 86403
2082 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 453-2828
2010 Injo Dr
Lk Havasu Cty, AZ 86403
Phone (623) 227-1000
1016 S Joshua Ave
Parker, AZ 85344
Phone (927) 669-6425
Interoperability endpoints
- paulmahnke@lprh.medalliesdirect.net
- paul.mahnke.1@3291.direct.athenahealth.com
- https://api.platform.athenahealth.com/3291/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP10571 | AZ | Yes |
Addresses
Primary practice location
2082 Mesquite Ave
Lake Havasu City, AZ 86403-6710
Mailing address
2082 Mesquite Ave
Lake Havasu City, AZ 86403-6710
Phone (928) 453-2727
Other providers in Lake Havasu City, AZ
- Nicole Mackey
- Shannon Donnel Macklem
- Made 4 Movement PLLC
- Maggies Lab Cab, LLC
- Brittney Mahnke
- Joseph Robert Majerus
- Sherry Kaye Malm
- Peter M. Mamalakis
- Manipulators Inc
- Misty Maple
All providers in Lake Havasu City, AZ · Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.