Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sidney Shane Mangelsdorf, AG-ACNP

Individual provider Acute Care Nurse Practitioner · NPI 1871950980

Sidney Shane Mangelsdorf, AG-ACNP is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2015, 11 years ago. Practices with St Joseph's Hospital and Medical Center, a 23-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
11
Licensed in
AZ
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

500 W Thomas Rd Ste 400
Phoenix, AZ 85013-4238
Phone: (602) 406-3874
Fax: (602) 406-2335
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence AP8394 (AZ)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence AP8394 (AZ)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence AP8394 (AZ)

Record details

NPI number1871950980
Entity typeIndividual (Type 1)
GenderMale
Credentials AG-ACNP
Sole proprietorYes
NPI enumeratedJanuary 20, 2016
Last updated in NPPESJune 8, 2026
Certification dateJune 8, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice St. Joseph'S Hospital And Medical Center — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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