NPIMap

Individual provider Active NPI

Andrew Peter Mangano, DO

  • Internal Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1043402480
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1658 Issued in SC
Practice address
920 Doug White Dr Ste 250
Myrtle Beach, SC 29572-4181
Phone
(843) 236-1950
Fax
(843) 236-1952
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1658 SC Primary
Internal Medicine Physician 207R00000X OT012273 PA

Addresses

Primary practice location

920 Doug White Dr Ste 250
Myrtle Beach, SC 29572-4181

Mailing address

920 Doug White Dr Ste 250
Myrtle Beach, SC 29572-4181
Phone (843) 236-1950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ANDREW.MANGANO@hca5.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220912001976 VA Practitioner - Internal Medicine 4486779212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Washington Hospital IncGroup PAC ID 0446143820, 53 clinicians

Practice addresses (Care Compare)

1201 B Sam Perry Blvd
Suite 280
Fredericksburg, VA 22401-8457
Phone (540) 741-5502

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1658SCMDChiropractor
OT012273PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians Current Accepting new patients
Mary Washington Hospital, Inc. CurrentSince May 1, 2023 Accepting new patients
Mary Washington Healthcare Providers LLC CurrentSince Aug 15, 2022 Accepting new patients
Pathology Associates of Fredericksburg PTR Current Accepting new patients
Mary Washington Hospital Inc. CurrentSince May 1, 2023 Accepting new patients

Locations

1201 Sam Perry Blvd
Ste 201
Fredericksburg, VA 22401
Phone (540) 741-1100

1201 Sam Perry Blvd
Ste 280
Fredericksburg, VA 22401
Phone (540) 361-2922

1201 Sam Perry Blvd
Ste 205
Fredericksburg, VA 22401
Phone (540) 374-3290

2300 Fall Hill Ave
Ste 317
Fredericksburg, VA 22401
Phone (540) 741-1041

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

Interoperability endpoints

  • Direct secure messaging: amangano95327@marywashingtonhealthcare.direct-ci.com
  • Direct secure messaging: andrew.mangano@hca5.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1043402480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 250",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724181",
            "telephone_number": "843-236-1950",
            "fax_number": "843-236-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 250",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724181",
            "telephone_number": "843-236-1950",
            "fax_number": "843-236-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANO",
        "first_name": "ANDREW",
        "middle_name": "PETER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2022-01-27",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "1658",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT012273",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ANDREW.MANGANO@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "920 Doug White Dr Ste 250",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295724181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.