Individual provider Active NPI

Glen Rocky Manzano, M.D.

  • Neurological Surgery Physician
  • Orlando, FL
National Provider Identifier
1093945867
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME104328 Issued in FL
Practice address
7460 Docs Grove Cir
Orlando, FL 32819-8010
Phone
(407) 423-7172
Fax
(407) 423-9505
NPI assigned
Jul 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME104328 FL Primary

Addresses

Primary practice location

7460 Docs Grove Cir
Orlando, FL 32819-8010

Mailing address

7460 Docs Grove Cir
Orlando, FL 32819-8010
Phone (407) 423-7172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20091106000265 FL Practitioner - Neurosurgery 3476691791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Miami, LM Miller School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Spine and Brain Neurosurgery CenterGroup PAC ID 6901838473, 3 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

7460 Docs Grove Cir
Orlando, FL 32819-8010
Phone (407) 903-9360

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
75.93 of 100Reported as individual
Quality
51.86
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion98
Laminectomy or laminotomy (partial removal of spine bones)51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
Spine & Brain Neurosurgery Center Neurological Surgery CurrentSince Jul 1, 2020 Accepting new patients
University of Miami Current Accepting new patients
Nizam Razack, PA Neurological Surgery Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1400 NW 12th Ave
Fl 1
Miami, FL 33136
Phone (305) 689-5511

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

7460 Docs Grove Cir
Orlando, FL 32819
Phone (407) 903-9360

32 W Gore St
Ste 511
Orlando, FL 32806
Phone (407) 423-7172

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: glen.manzano.1@11845.direct.athenahealth.com
  • Direct secure messaging: gmanzano31786@direct.med.miami.edu
  • FHIR API: https://api.platform.athenahealth.com/11845/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 3

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1093945867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7460 DOCS GROVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198010",
            "telephone_number": "407-423-7172",
            "fax_number": "407-423-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7460 DOCS GROVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198010",
            "telephone_number": "407-423-7172",
            "fax_number": "407-423-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "GLEN",
        "middle_name": "ROCKY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME104328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.