Individual provider Active NPI

Anastasios Manaris, MD

  • Cardiovascular Disease Physician
  • West Islip, NY
National Provider Identifier
1104806561
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
1945031 Issued in NY
Practice address
540 Union Blvd
West Islip, NY 11795-3105
Phone
(631) 669-2555
Fax
(631) 669-5787
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 1945031 NY Primary

Addresses

Primary practice location

540 Union Blvd
West Islip, NY 11795-3105

Mailing address

500 Montauk Hwy
Ste S
West Islip, NY 11795-4420
Phone (631) 940-9009

Other identifiers 1

IdentifierTypeStateIssuer
02075152MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090912000092 NY Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4981750189 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Ekg Interpretation, P. C.Group PAC ID 2466345103, 57 clinicians
Icahn School of Medicine at Mount SinaiGroup PAC ID 6709174493, 17 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 465-6225

200 Old Country Rd
Suite 520
Mineola, NY 11501-4298
Phone (516) 877-0977

5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone (631) 628-5000

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 465-6225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1945031NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince May 20, 2020 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince May 20, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai Cardiovascular Disease CurrentSince May 7, 2022 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

5 Cuba Hill Rd
Greenlawn, NY 11740
Phone (631) 628-5000

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

8002 Kew Gardens Rd
Ste 323
Kew Gardens, NY 11415
Phone (718) 268-6300

200 Old Country Rd
Ste 520
Mineola, NY 11501
Phone (516) 877-0977

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

100 Port Washington Blvd
Ste 105
Roslyn, NY 11576
Phone (516) 390-9640

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1104806561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MONTAUK HWY",
            "address_2": "STE S",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954420",
            "telephone_number": "631-940-9009",
            "fax_number": "631-940-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 UNION BLVD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953105",
            "telephone_number": "631-669-2555",
            "fax_number": "631-669-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANARIS",
        "first_name": "ANASTASIOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "1945031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02075152",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.