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MICHAEL ANTHONY MANZANO
NPI 1376117598
Student in an Organized Health Care Education/Training Program in San Diego, CA

Active since May 13, 2021PECOS Enrolled
3665 KEARNY VILLA RD STE 101, SAN DIEGO, CA 92123(949) 874-2757 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Michael Anthony Manzano NPPES

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

MICHAEL ANTHONY MANZANO (NPI 1376117598) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of University Of California, San Diego School Of Medicine (2024).

NPPES Registry Identity

NPI1376117598
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMICHAEL ANTHONY MANZANO
Location Address3665 KEARNY VILLA RD STE 101San Diego, CA 92123-1954
Mailing Address3754 1st Ave Apt CSan Diego, CA 92103-4089 · (949) 874-2757
Phone(949) 874-2757
Sole ProprietorNo
Medical School CMSUniversity Of California, San Diego School Of MedicineGraduated 2024
Enumeration DateMay 13, 2021
NPPES CertifiedMay 13, 2021
✔ NPI 1376117598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3665 KEARNY VILLA RD STE 101, San Diego, CA 92123
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Secondary Practice Location 1

Location 13754 1st Ave Apt CSan Diego, CA 92103-4089 · Phone (949) 874-2757

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Anthony Manzano is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3375027808
PECOS Enrollment IDI20260323001195
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.

Medicare Billing Reassignment

Medicare enrollment records show Michael Manzano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
416 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEANNA CATHERINE LACK
Social Worker
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832
SARA VIEREGG
Marriage & Family Therapist
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 576-1700
MRS. EMILY FANNAN LCSW
Social Worker (Clinical)
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832
GABRIELA CASTELLANOS
Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832
SUJIN CHEN
Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832
BRENDA LIZETH LOPEZ ASW
Social Worker
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832
SABA FARIDI
Student in an Organized Health Care Education/Training Program
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832
MISS TAHITI DOMINGUEZ
Social Worker (Clinical)
3665 KEARNY VILLA RD STE 101
SAN DIEGO, CA 92123
San Diego County (858) 966-5832

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 Michael Manzano's NPI number?

The NPI number for Michael Manzano is 1376117598. It was assigned to this individual provider in the NPPES registry on May 13, 2021.

Where is Michael Manzano located?

Michael Manzano practices at 3665 Kearny Villa Rd Ste 101, San Diego, CA 92123. The listed phone number is (949) 874-2757.

What is Michael Manzano's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michael Manzano enrolled in Medicare?

Yes. Michael Manzano is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Michael Manzano's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Manzano reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Manzano's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michael Manzano was last updated on May 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.