Alexis Jacklyn Manzella

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

RN2377937 Issued in MA

Practice address

25 Libby St
Brockton, MA 02302-2949

Phone

(508) 941-7700

NPI assigned

May 3, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexis.manzella@direct.signature.masshiway.net

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.

• Signature Healthcare Medical Group Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949
  Medicare reassignment Care Compare group
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914
  Medicare reassignment
• Engrace Behavioral Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Randolph, MA
  • NPI 1013416387
  Medicare reassignment
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Needham, MA
  • NPI 1053862045
  NPD
• Atrius Health, Inc.

  • Internal Medicine Physician
  • Beverly, MA
  • NPI 1114265634
  NPD

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

• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  Care Compare affiliation

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1083461248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CONCORD ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021292571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LIBBY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022949",
            "telephone_number": "508-941-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Concord St Apt 3",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021292571",
            "country_code": "US",
            "telephone_number": "914-715-1672",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-894-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZELLA",
        "first_name": "ALEXIS",
        "middle_name": "JACKLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2377937",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MA",
            "license": "RN2377937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Faye Manning, PHD
• Theresa Mae Manning
• Rana Mansour, M.D.
• Michele A Manting, MD
• Meghan Mantler, MSW
• Maranatha Staffing
• Darma Marcelin
• Kurt Marcella, PTA
• Carvens Marcellus
• Rubenza Joya Marcellus

• Medical-Surgical Registered Nurse in Brockton, MA
• Providers in Brockton, MA by specialty
• Medical-Surgical Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.