Patrick Terry Mangonon, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

ME77600 Issued in FL

Practice address

305 Memorial Medical Pkwy
Suite 308
Daytona Beach, FL 32117-5168

Phone

(386) 231-3600

Fax

(386) 231-3602

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Thoracic Surgery

Education

University of Miami, LM Miller School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
• Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• FL PPO
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: pmangonon58953@adventhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  Medicare reassignment Care Compare group NPD
• Patrick Mangonon MD PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Loxahatchee, FL
  • NPI 1952446536
  NPD (past) Authorized official
• Thoracic & Cardiovascular Surgeons LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Atlantis, FL
  • NPI 1649212416
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Palm Coast Parkway Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1861102345
  Care Compare affiliation
• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1023067584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 308",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175168",
            "telephone_number": "386-231-3600",
            "fax_number": "386-231-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 308",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175168",
            "telephone_number": "386-231-3600",
            "fax_number": "386-231-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGONON",
        "first_name": "PATRICK",
        "middle_name": "TERRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME77600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256707500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Maloney
• Logan Malter
• Julia Malysh
• Stasia Golembiewska Manak, LCSW
• Rebecca Hema Mangali, PA-C
• Courtney Mangum, MD
• Marissa N Mangum, APRN
• Meredith A. Manley Beck, CRNA
• Anitra Manning, RBT
• Asia Manning

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.