Gary R Manasse, D.M.D., P.A.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN13435 Issued in FL

Practice address

8708 Perimeter Park Blvd.
#3
Jacksonville, FL 32216

Phone

(904) 646-1414

Fax

(904) 646-1454

NPI assigned

Mar 27, 2013

Last updated

Mar 29, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Gary R Manasse DMD PA

  • Endodontics
  • Jacksonville, FL
  • NPI 1992804595
  NPD (past) Authorized official

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1023351152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 PERIMETER PARK BLVD.",
            "address_2": "#3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-646-1414",
            "fax_number": "904-646-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 PERIMETER PARK BLVD.",
            "address_2": "#3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-646-1414",
            "fax_number": "904-646-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANASSE",
        "first_name": "GARY",
        "middle_name": "R",
        "credential": "D.M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vipul B Mamtora
• Managed Access to Child Health Inc
• Lianne Mananquil, CAA
• Almira Manaois, P.T.
• Adrienne Manasco, PSYD
• Miguel Mancao III
• Lynda R. Mance, L.C.S.W., CEAP, SAP
• Alisha M Mancebo
• Clarissa Mancheno, CRNA
• Andrew Benjamin Mancia, DMD

• Endodontics in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.