Mitchell Ryan Manway, D.O.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

7027 Issued in AZ

Practice address

20401 N 73Rd St Ste 230
Scottsdale, AZ 85255-4153

Phone

(480) 556-0446

Fax

(480) 556-0447

NPI assigned

Apr 30, 2014

Last updated

Feb 20, 2024By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Dermatology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard Lee Averitte Jr PLLCGroup PAC ID 9638069099, 31 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mitchellmanway@ad.allscriptsdirect.net
• Direct secure messaging: mmanway@affderm.emadirect.md

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.

• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1407804115
  Medicare reassignment Care Compare group NPD
• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609291848
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Surprise, AZ
  • NPI 1598112831
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Anthem, AZ
  • NPI 1619428851
  NPD (past)

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1083024921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20401 N 73RD ST",
            "address_2": "SUITE 230",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554107",
            "telephone_number": "480-556-0446",
            "fax_number": "480-556-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20401 N 73RD ST STE 230",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554153",
            "telephone_number": "480-556-0446",
            "fax_number": "480-556-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANWAY",
        "first_name": "MITCHELL",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2024-02-20",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "7027",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "7027",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "007027",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS13524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rania Mansour, MBBS, MPH
• Trina Mansour
• Nick Mansourian, DDS
• Erica Mantel
• James X Manuel, R PH
• Maple Leaf PC (Arizona Spinal Care)
• Jacob Emanuel Mapp, MD
• Valerie Marbach, MED PLC
• Marbella Dental Consultants LLC
• Marbella Dental Studio

• MOHS-Micrographic Surgery Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• MOHS-Micrographic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.