NPIMap

Individual provider Active NPI

Patrick Terry Mangonon, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Daytona Beach, FL
National Provider Identifier
1023067584
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
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
Last updated
Oct 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME77600 FL Primary

Addresses

Primary practice location

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

Mailing address

305 Memorial Medical Pkwy
Suite 308
Daytona Beach, FL 32117-5168
Phone (386) 231-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050414000293 FL Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 1759328461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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)

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Healthcare Partners, Inc CurrentSince Nov 4, 2024 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Patrick Mangonon MD PA Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

301 Memorial Medical Pkwy
Daytona Beach, FL 32117
Phone (386) 231-3906

305 Memorial Medical Pkwy
Ste 300
Daytona Beach, FL 32117
Phone (386) 231-3513

305 Memorial Medical Pkwy
Ste 308
Daytona Beach, FL 32117
Phone (386) 231-3072

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

1061 Medical Center Dr
Ste 212
Orange City, FL 32763
Phone (386) 774-0109

3 Adventhealth Way
Ste 220
Palm Coast, FL 32137

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

61 Memorial Medical Pkwy
Ste 1-800A
Palm Coast, FL 32164
Phone (386) 586-1810

Networks

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

Interoperability endpoints

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

Organizations & group practices 3

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

Hospital & facility affiliations 5

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

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.