Oswaldo Giovanni Tagle Manrique, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA061118 Issued in PA

Practice address

1575 Pond Rd Ste 203
Allentown, PA 18104-2254

Phone

(610) 366-1366

NPI assigned

Nov 13, 2019

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 2

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

Specialty

Physician Assistant

Education

Pennsylvania State University College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14176/brand/1/csg/1/fhir/r4

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.

• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment Care Compare group
• Lehigh Valley Weight Loss LLC

  • Obesity Medicine (Preventive Medicine) Physician
  • Allentown, PA
  • NPI 1679013098
  Medicare reassignment
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • Whitehall, PA
  • NPI 1962963199
  NPD

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

• Lehigh Valley Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1164400131
  Care Compare affiliation
• Lehigh Valley Hospital

  • Clinic/Center
  • Allentown, PA
  • NPI 1194673467

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital

  • Clinic/Center
  • Allentown, PA
  • NPI 1528627155

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital

  • Psychiatric Hospital Unit
  • Bethlehem, PA
  • NPI 1609834001
  Care Compare affiliation
• Lehigh Valley Hospital

  • Children's Hospital
  • Allentown, PA
  • NPI 1952954307
  Care Compare affiliation

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1063057040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 INDIAN CREEK RD",
            "city": "EMMAUS",
            "state": "PA",
            "postal_code": "180491909",
            "telephone_number": "610-704-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 POND RD STE 203",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042254",
            "telephone_number": "610-366-1366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Mokychic Road",
            "address_purpose": "LOCATION",
            "city": "Collegeville",
            "state": "PA",
            "postal_code": "19426",
            "country_code": "US",
            "telephone_number": "610-409-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Hamilton St Ste 111",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181046329",
            "country_code": "US",
            "telephone_number": "610-821-8321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAGLE MANRIQUE",
        "first_name": "OSWALDO",
        "middle_name": "GIOVANNI",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PHYSICIAN ASSISTANT LICENSE",
            "identifier": "MA061118",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC PHYSICIAN ASSISTANT LICENSE",
            "identifier": "OA005038",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kevin Taber, PA-C
• Navid Tabibzadeh, D.O.
• Archana Tadisena
• Mykel Gamil Tadros, DO
• Lauren Taggart, ATR-BC, LPC
• Mahmood Tahir, MD
• Iram Taimur, PTA
• Alexa Mae Talbot
• John Talley, M.S., CCC-SLP/L
• Jay S. Talsania, MD

• Medical Physician Assistant in Allentown, PA
• Providers in Allentown, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.