Marc Angelo Mancuso, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

200700335 Issued in NC

Practice address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Phone

(704) 334-7800

Fax

(704) 414-7512

NPI assigned

Dec 19, 2005

Last updated

Dec 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

University of Massachusetts Medical School, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
• Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098
• Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Charlotte Radiology P a

  • Specialist
  • Charlotte, NC
  • NPI 1649220443

  SC

  Medicare reassignment Care Compare group
• Blue Ridge Healthcare Medical Group, Inc.

  dba Women's Health Group-Valdese

  • Obstetrics & Gynecology Physician
  • Connelly Springs, NC
  • NPI 1467993931
  Medicare reassignment NPD
• Blue Ridge Healthcare Medical Group, Inc.

  dba Blue Ridge Transitional Care Clinic

  • Internal Medicine Physician
  • Morganton, NC
  • NPI 1578424685
  NPD
• Blue Ridge Healthcare Medical Group, Inc.

  dba Alan F. Jacks, MD, PA

  • Surgery Physician
  • Connelly Springs, NC
  • NPI 1740558949
  NPD
• Blue Ridge Healthcare Medical Group Inc

  dba Blue Ridge Radiology

  • Diagnostic Radiology Physician
  • Hickory, NC
  • NPI 1578842035
  NPD (past)
• Charlotte Radiology PA

  • Diagnostic Radiology Physician
  • Charlotte, NC
  • NPI 1003110677
  NPD (past)

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

• Carolinas Medical Center

  dba Atrium Health Behavioral Health

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Mercy

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  dba Levine Children's Hospital Pediatrics

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Laboratory

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1417432840
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Cabarrus

  • General Acute Care Hospital
  • Concord, NC
  • NPI 1487866315
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Cabarrus Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  Care Compare affiliation

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1063498418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035823",
            "country_code": "US",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "MARC",
        "middle_name": "ANGELO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NC",
            "license": "200700335",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "12626",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "227556",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "29892",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200700335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00337",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906571",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICAIRE",
            "identifier": "P00410888",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronaldo Cruz Mamaril, NP
• Grace Anne Mammes, LDN. RD
• Trina Magno Manalo, MD
• Samyak Manandhar, MD
• Megan Mancini, LPA, MA
• Jayaprakash Manda, MD
• Lalita Shraavya Mandavilli, MD
• Jessica Eden Mandell, PHD
• Lyndsey Helms Mander, NP
• Warsha Kumari Mandhan, MD

• Diagnostic Radiology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.