Active NPI
Marlon Mangahas, M.D.
- Psychiatry Physician
- Coatesville, PA
National Provider Identifier
1093916439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2007006296
- Practice address
- 1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040 - Phone
- (610) 384-7711
- NPI assigned
- May 31, 2007
- Last updated
- Oct 17, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2007006296 | MO | Primary |
Addresses
Primary practice location
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Mailing address
8835 Wrenwood LN
Brentwood, MO 63144-1703
Phone (314) 962-1339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 4, 2020 through Nov 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- mmangahas198239@directc.mercy.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1093916439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8835 WRENWOOD LN",
"city": "BRENTWOOD",
"state": "MO",
"postal_code": "631441703",
"telephone_number": "314-962-1339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGAHAS",
"first_name": "MARLON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-31",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2007006296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coatesville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.