Individual provider Active NPI

Thomas Francis Mannino, MD

  • Diagnostic Radiology Physician
  • Glen Cove, NY
National Provider Identifier
1104894831
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
203089 Issued in NY
Practice address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone
(516) 674-7540
Fax
(516) 674-7546
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 203089 NY Primary

Addresses

Primary practice location

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Mailing address

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (516) 674-7540

Other identifiers 1

IdentifierTypeStateIssuer
01709439MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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
I20050115000106 NY Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 2860441995 Reassigns benefits to 2 organizations
I20230707000610 FL Practitioner - Diagnostic Radiology 2860441995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York at Stony Brook, School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 1254640253, 17 clinicians

Practice addresses (Care Compare)

3722 82ND St
Jackson Heights, NY 11372-7040
Phone (718) 879-1600

575 Fern St
West Palm Beach, FL 33401-5725
Phone (561) 268-2000

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203089NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Feb 5, 2019 Accepting new patients
Fpa Hospital Based CurrentSince Feb 5, 2019 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology CurrentSince Feb 24, 2019 Accepting new patients
Fpa Hospital Based Current Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Feb 24, 2019 Accepting new patients
North Shore Radiology at Glen Cove PC PastSince Sep 1, 2010 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
St Catherine of Siena Medical Center Past Accepting new patients
Radiology Consulting of Long Island PLLC Diagnostic Radiology Past Accepting new patients

Locations

600 University Blvd
Ste 200
Jupiter, FL 33458
Phone (561) 627-2210

575 Fern St
West Palm Beach, FL 33401
Phone (561) 268-2000

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

1436 Broadway
Hewlett, NY 11557
Phone (516) 563-7200

120 New York Ave
Huntington, NY 11743
Phone (631) 351-3766

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

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

3722 82nd St
Jackson Hts, NY 11372
Phone (718) 779-1600

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

1468 Madison Ave
#175
New York, NY 10029
Phone (212) 241-8333

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

116 Fifth Ave
Pelham, NY 10803
Phone (914) 738-0005

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

341 Central Park Ave
Scarsdale, NY 10583
Phone (718) 676-5309

2020 Wantagh Ave
Wantagh, NY 11793
Phone (516) 248-2422

1086 N Broadway
Yonkers, NY 10701
Phone (914) 771-9666

Networks

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

Organizations & group practices 11

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104894831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7540",
            "fax_number": "516-674-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7540",
            "fax_number": "516-674-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "THOMAS",
        "middle_name": "FRANCIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "203089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01709439",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.