Individual provider Active NPI

James A. Manganiello, EDD.

  • Psychologist
  • Essex, MA
National Provider Identifier
1003997073
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1690 Issued in MA
Practice address
33 Conomo Point Rd
Essex, MA 01929-1040
Phone
(978) 979-4480
Fax
(978) 768-2589
NPI assigned
Oct 18, 2006
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1690 MA Primary

Addresses

Primary practice location

33 Conomo Point Rd
Essex, MA 01929-1040

Mailing address

2 Center St
Groveland, MA 01834-1001
Phone (617) 939-1933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000049 MA Practitioner - Clinical Psychologist 1052445608 Practice locations: Essex, MA; Groveland, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Ctr St
Groveland, MA 01834-1001
Phone (978) 914-7733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1690MAMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1003997073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CENTER ST",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018341001",
            "telephone_number": "617-939-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CONOMO POINT RD",
            "city": "ESSEX",
            "state": "MA",
            "postal_code": "019291040",
            "telephone_number": "978-979-4480",
            "fax_number": "978-768-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANIELLO",
        "first_name": "JAMES",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "EDD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "1690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, MA

Sources for this page

Verify at the official NPI Registry.