Sidney Shane Mangelsdorf, AG-ACNP - Medicare Nurse Practitioner in Phoenix, AZ

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Sidney Shane Mangelsdorf, AG-ACNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Phoenix, Arizona. He graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Affiliated Hospitalists Plc, St. Joseph's Hospital And Medical Center and his current practice location is 500 W Thomas Rd Ste 400, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 406-3874.

Sidney Shane Mangelsdorf is licensed to practice in Arizona (license number AP8394) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1871950980.

Contact Information

Sidney Shane Mangelsdorf, AG-ACNP
500 W Thomas Rd Ste 400,
Phoenix, AZ 85013
(602) 406-3874
(602) 406-2335

Map and Direction




Provider's Profile

Full NameSidney Shane Mangelsdorf
GenderMale
SpecialityNurse Practitioner
Experience9 Years
Location500 W Thomas Rd Ste 400, Phoenix, Arizona
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Sidney Shane Mangelsdorf graduated from nursing school in 2015
  NPI Data:
  • NPI Number: 1871950980
  • Provider Enumeration Date: 01/20/2016
  • Last Update Date: 09/28/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7810268521
  • Enrollment ID: I20170728002543

Medical Identifiers

Medical identifiers for Sidney Shane Mangelsdorf such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871950980NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care AP8394 (Arizona)Secondary
363LG0600XNurse Practitioner - Gerontology AP8394 (Arizona)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St. Joseph's Hospital And Medical CenterPhoenix, AZHospital
Osborn Health And RehabilitationScottsdale, AZNursing home

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Affiliated Hospitalists Plc620482286981
St. Joseph's Hospital And Medical Center670986317825

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sidney Shane Mangelsdorf allows following entities to bill medicare on his behalf.
Entity NameSjhmc Physician Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326098005
PECOS PAC ID: 4486646197
Enrollment ID: O20040401001189
Entity NameAffiliated Hospitalists Plc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265546261
PECOS PAC ID: 6204822869
Enrollment ID: O20040421000567
Entity NameChandler Regional Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871910968
PECOS PAC ID: 5395729784
Enrollment ID: O20040615000027
Entity NameSt. Joseph's Hospital And Medical Center C/o Dignity Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255382412
PECOS PAC ID: 6709863178
Enrollment ID: O20040702000601
Entity NameLeading Healthcare, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356853691
PECOS PAC ID: 1850652496
Enrollment ID: O20180222002817

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sidney Shane Mangelsdorf is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Sidney Shane Mangelsdorf, AG-ACNP
Po Box 33269,
Phoenix, AZ 85067-3269

Ph: (602) 406-4786		Sidney Shane Mangelsdorf, AG-ACNP
500 W Thomas Rd Ste 400,
Phoenix, AZ 85013

Ph: (602) 406-3874

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.