SIDNEY SHANE MANGELSDORF AG-ACNP NPI 1871950980

NPI Information

  • NPI: 1871950980
  • Provider Name: SIDNEY SHANE MANGELSDORF, AG-ACNP
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 500 W THOMAS RD STE 400
    PHOENIX, AZ
    ZIP 85013
  • Phone: (602) 406-3874

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NPI Details

Sidney Shane Mangelsdorf, AG-ACNP is an acute care nurse practitioner in Phoenix, AZ with 10 years of experience. Sidney Shane Mangelsdorf, AG-ACNP NPI is 1871950980. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

500 W THOMAS RD STE 400
PHOENIX, AZ
ZIP 85013-238
Phone: (602) 406-3874
Fax: (602) 406-2335

The NPI 1871950980 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)

The enumeration date for this NPI number is 1/20/2016 and was last updated on 1/9/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthAP8394ARIZONANo
2363LG0600XNurse PractitionerGerontologyAP8394ARIZONANo
3363LA2100XNurse PractitionerAcute CareAP8394ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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