Individual provider Active NPI

Nicholas Manguso, MD

  • Surgery Physician
  • Reno, NV
National Provider Identifier
1093199457
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22231 Issued in NV
Practice address
1500 E 2ND St Ste 300
Reno, NV 89502-1198
Phone
(775) 982-5000
Fax
(775) 982-3900
NPI assigned
Jul 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 137149 CA
Surgery Physician 208600000X 22231 NV Primary

Addresses

Primary practice location

1500 E 2ND St Ste 300
Reno, NV 89502-1198

Mailing address

1500 E 2ND St Ste 300
Reno, NV 89502-1198
Phone (775) 982-5000

Other identifiers 2

IdentifierTypeStateIssuer
13863245OtherNVCAQH #
22231OtherNVNV LIC#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 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

Enrollment IDStateProvider typePAC IDDetails
I20160829002477 CA Practitioner - General Surgery 8022307818 Reassigns benefits to 1 organization
I20220816001558 NV Practitioner - General Surgery 8022307818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1500 E 2ND St
Suite 300
Reno, NV 89502-1198
Phone (775) 982-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision11
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
137149CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Aug 2, 2022 Accepting new patients
Community Care Services LLC Current Accepting new patients
Community Care Services LLC CurrentSince Aug 2, 2022 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

75 Pringle Way
Ste 900
Reno, NV 89502
Phone (775) 982-6270

10201 Double R Blvd
Ste 315
Reno, NV 89521
Phone (775) 982-3443

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

1500 E 2nd St
Ste 300
Reno, NV 89502
Phone (775) 322-7811

Interoperability endpoints

  • Direct secure messaging: nmanguso190674@direct.renown.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1093199457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 300",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 300",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUSO",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "137149",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "22231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH #",
            "identifier": "13863245",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV LIC#",
            "identifier": "22231",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.