Active NPI
Catherine Concepcion Mangalili, APRN
- Gerontology Nurse Practitioner
- Lakeland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- APRN11020578
- Practice address
- 1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019 - Phone
- (863) 680-7000
- Fax
- (866) 264-8519
- NPI assigned
- Jul 12, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | APRN11020578 | FL | Primary |
| Nurse Practitioner | 363L00000X | 11020578 | FL |
Addresses
Primary practice location
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Mailing address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cmangalili20994@direct.watsonclinicad.com | Watson Clinic LLP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.18 of 100
- Quality
- 70.68
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11020578 | FL | MD | Nurse Practitioner |
| APRN11020578 | FL | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Post Acute Specialists of Florida PLLC | Nurse Practitioner | Current | Accepting new patients |
| Watson Clinic LLP | Current | Accepting new patients |
Locations
1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190
1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337
508 S Habana Ave
Ste 300
Tampa, FL 33609
Phone (813) 877-6770
2203 N Lois Ave
Ste 814
Tampa, FL 33607
Phone (813) 505-5060
Interoperability endpoints
- cmangalili20994@direct.watsonclinicad.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Lakeland, FL
- NPI 1316940695
-
- Internal Medicine Physician
- Bradenton, FL
- NPI 1992571608
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1982338232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053065",
"telephone_number": "863-680-7000",
"fax_number": "866-264-8519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053019",
"telephone_number": "863-680-7000",
"fax_number": "866-264-8519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGALILI",
"first_name": "CATHERINE",
"middle_name": "CONCEPCION",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "FL",
"license": "APRN11020578",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11020578",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cmangalili20994@direct.watsonclinicad.com",
"affiliation": "Y",
"endpointDescription": "Direct Messaging Address",
"affiliationName": "Watson Clinic LLP",
"address_1": "1430 Lakeland Hills Blvd",
"city": "Lakeland",
"state": "FL",
"country_code": "US",
"postal_code": "338053202",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.