ELIZABETH KARENINA MANULLANG – Certified Registered Nurse Anesthetist, NPI 1063989382

ELIZABETH KARENINA MANULLANG is a healthcare provider. based in Colton, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 756129 (CA). The NPI Number for ELIZABETH KARENINA MANULLANG is 1063989382

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH KARENINA MANULLANG
NPI
1063989382
Phone
(877) 873-2762
Address
400 N PEPPER AVE
Enumeration Date
24 October 2018
Last Update Date
24 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9095802440
Graduation Year
2018 (8 years ago)
PAC ID
1355674920
Group Practice PAC ID
1052310331
Professional Enrollment ID
I20190613001401
Address ID
CA923241801CO400XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

2,456 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

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Provider Addresses for ELIZABETH KARENINA MANULLANG

  • 400, Pepper Avenue, West Colton, Colton, San Bernardino County, California, 92324, United States

    COLTON, CA 923241801

    Phone: (877) 873-2762

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-06-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190613001401ICertified Registered Nurse Anesthetist (Crna)CATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92324)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052310331View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YOH
-CA
A N E S T H E S I O L O G YCA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
A N E S T H E S I O L O G YCA
Certified Registered Nurse Anesthetist (Crna)CA
-CA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA

Reviews

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Frequently asked questions

What federal number belongs to ELIZABETH KARENINA MANULLANG?
The federal identifier for ELIZABETH KARENINA MANULLANG is NPI 1063989382.
Does this profile mean ELIZABETH KARENINA MANULLANG is currently active?
Yes — ELIZABETH KARENINA MANULLANG appears active in the national provider directory.
What kind of provider is ELIZABETH KARENINA MANULLANG?
The page reflects Certified Registered Nurse Anesthetist for ELIZABETH KARENINA MANULLANG. Clinical services aligned with this taxonomy classification.
Where is ELIZABETH KARENINA MANULLANG's primary listing?
We display Colton, California because that is what the record indicates for ELIZABETH KARENINA MANULLANG.
What if Colton, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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