Individual provider Active NPI

Milagros M Manzano, PA-C

  • Physician Assistant
  • Norristown, PA
National Provider Identifier
1053529693
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA003086L Issued in PA
Practice address
1401 Dekalb St
Norristown, PA 19401-3405
Phone
(610) 278-7787
Fax
(610) 278-7386
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA003086L PA Primary

Addresses

Primary practice location

1401 Dekalb St
Norristown, PA 19401-3405

Mailing address

1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone (215) 599-4851

Other identifiers 1

IdentifierTypeStateIssuer
103207143MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address milagros.manzano@direct.dvch.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151012001658 PA Practitioner - Physician Assistant 9436468568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Community Health, Inc. CurrentSince Aug 25, 2015 Accepting new patients
Delaware Valley Community Health, Inc. CurrentSince Aug 25, 2015 Accepting new patients

Locations

1401 DeKalb St
Norristown, PA 19401
Phone (610) 275-9400

1412 Fairmount Ave
Philadelphia, PA 19130
Phone (215) 235-9600

Interoperability endpoints

  • Direct secure messaging: milagros.manzano@direct.dvch.nextgenshare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1053529693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "215-599-4851",
            "fax_number": "215-232-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DEKALB ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013405",
            "telephone_number": "610-278-7787",
            "fax_number": "610-278-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "MILAGROS",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003086L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103207143",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "milagros.manzano@direct.dvch.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1401 Dekalb St",
            "city": "Norristown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194013405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norristown, PA

Sources for this page

Verify at the official NPI Registry.