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ANGELA MANJGALADZE
NPI 1194281444
Nurse Practitioner - Psychiatric/Mental Health in Victor, NY

Active since February 12, 2019PECOS EnrolledAccepts Medicare Assignment
600 FISHERS STATION DR STE 117, VICTOR, NY 14564(585) 337-0992(585) 337-0998 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 1, 2023, Feb 4, 2020, Feb 12, 2019 (3 updates tracked since 2019).

About Angela Manjgaladze NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGELA MANJGALADZE (NPI 1194281444) is an individual psychiatric/mental health provider in Victor, New York, licensed in New York (402705) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1194281444
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameANGELA MANJGALADZE
Location Address600 FISHERS STATION DR STE 117Victor, NY 14564-9784
Mailing Address600 Fishers Station Dr Ste 117Victor, NY 14564-9784 · (585) 337-0992 · Fax (585) 337-0998
Phone(585) 337-0992
Fax(585) 337-0998
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateFebruary 12, 2019
Last NPPES UpdateFebruary 1, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2021
✔ NPI 1194281444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · 402705
Also ListedNurse PractitionerTaxonomy 363L00000X · License 001782 (NY)
600 FISHERS STATION DR STE 117, Victor, NY 14564
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Angela Manjgaladze is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557698834
PECOS Enrollment IDI20190808002913
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14564 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angela Manjgaladze's NPI number?

The NPI number for Angela Manjgaladze is 1194281444. It was assigned to this individual provider in the NPPES registry on February 12, 2019.

Where is Angela Manjgaladze located?

Angela Manjgaladze practices at 600 Fishers Station Dr Ste 117, Victor, NY 14564. The listed phone number is (585) 337-0992.

What is Angela Manjgaladze's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Angela Manjgaladze enrolled in Medicare?

Yes. Angela Manjgaladze is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Angela Manjgaladze accept?

Health plans from Providence Health Plan list Angela Manjgaladze as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Angela Manjgaladze was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.