1. Home
  2. Directory
  3. California
  4. San Diego
  5. Pediatrics
  6. NPI Profile

KATHERINE ANN MANDEVILLE MD
NPI 1649355397
Pediatrics - Pediatric Emergency Medicine in San Diego, CA

Active since October 25, 2006PECOS Enrolled
3020 CHILDRENS WAY, SAN DIEGO, CA 92123(858) 966-8036(858) 966-7433 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Nov 7, 2017, Oct 23, 2017 and 1 more (4 updates tracked since 2016).

About Katherine Ann Mandeville Md NPPES

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

KATHERINE ANN MANDEVILLE MD (NPI 1649355397) is an individual pediatric emergency medicine provider in San Diego, California, licensed in California (C149595) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649355397
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameKATHERINE ANN MANDEVILLECredential: MD
Location Address3020 CHILDRENS WAYSan Diego, CA 92123-4223
Mailing Address3020 Childrens Way # Mc5003San Diego, CA 92123-4223 · (858) 309-6300
Phone(858) 966-8036
Fax(858) 966-7433
Sole ProprietorNo
Enumeration DateOctober 25, 2006
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
✔ NPI 1649355397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in CA · C149595
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License C149595 (CA)
3020 CHILDRENS WAY, San Diego, CA 92123
Open in Google Maps ↗

Other Identifiers 1

Medicaid22807349CO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katherine Ann Mandeville Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. NATALIE E. ELLINGTON MD
Pathology (Pediatric Pathology)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-5944
SHANNA MICHAEL MILLER-NABAS RDN
Physician Assistant
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 576-1700
DR. ADRIANA HERRERA TREMOULET M.D.
Pediatrics (Pediatric Infectious Diseases)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-7785
LORI MCCURDY M.S., CCC-SLP
Speech-Language Pathologist
3020 CHILDRENS WAY, MC5010
SAN DIEGO, CA 92123
San Diego County (858) 968-5838
MS. ANN M SUMIDA-JOHNSON M.A..
Audiologist
3020 CHILDRENS WAY, MC 5010
SAN DIEGO, CA 92123
San Diego County (858) 966-5838
RICHARD JOHN NEWTON M.D.
Pediatrics
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-8036
DR. SHAHFAR KHAN M.D.
Pediatrics (Pediatric Emergency Medicine)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-8800
CARLY BETH WELCH CPNP-AC
Nurse Practitioner (Pediatrics)
3020 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-8800

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 Katherine Mandeville's NPI number?

The NPI number for Katherine Mandeville is 1649355397. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Katherine Mandeville located?

Katherine Mandeville practices at 3020 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 966-8036.

What is Katherine Mandeville's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Katherine Mandeville enrolled in Medicare?

Yes. Katherine Mandeville is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Katherine Mandeville was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.