Individual provider Active NPI

Anthony P Mannarino, PHD

  • Clinical Psychologist
  • Pittsburgh, PA
National Provider Identifier
1114928371
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS002739L Issued in PA
Practice address
4 Allegheny Ctr FL 8
Pittsburgh, PA 15212-5255
Phone
(412) 330-4000
Fax
(412) 330-4366
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PS002739L PA
Clinical Psychologist 103TC0700X PS002739L PA Primary

Addresses

Primary practice location

4 Allegheny Ctr FL 8
Pittsburgh, PA 15212-5255

Mailing address

4 Allegheny Ctr FL 8
Pittsburgh, PA 15212-5255
Phone (412) 330-4000

Other identifiers 1

IdentifierTypeStateIssuer
001448806MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amannarino11116@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000067 PA Practitioner - Clinical Psychologist 8022140888 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS002739LPAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Clinical CurrentSince Mar 6, 2010 Accepting new patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Mar 6, 2010 Accepting new patients
Allegheny Clinic Clinical Past Accepting new patients

Locations

2315 Myrtle St
Ste 260
Erie, PA 16502
Phone (814) 452-6558

4 Allegheny Ctr
Fl 8
Pittsburgh, PA 15212
Phone (412) 330-4242

Interoperability endpoints

  • Direct secure messaging: amannarino11116@direct.ahn.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1114928371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ALLEGHENY CTR FL 8",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152125255",
            "telephone_number": "412-330-4000",
            "fax_number": "412-330-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ALLEGHENY CTR FL 8",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152125255",
            "telephone_number": "412-330-4000",
            "fax_number": "412-330-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNARINO",
        "first_name": "ANTHONY",
        "middle_name": "P",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS002739L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS002739L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001448806",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amannarino11116@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4 Allegheny Ctr Fl 8",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152125255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.