Individual provider Active NPI

John E Manos, MD

  • Anesthesiology Physician
  • Wellesley, MA
National Provider Identifier
1154402345
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
47886 Issued in MA
Practice address
1 Washington St Ste 302
Wellesley, MA 02481-1706
Phone
(404) 667-5646
NPI assigned
Oct 17, 2006
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 47886 MA Primary

Addresses

Primary practice location

1 Washington St Ste 302
Wellesley, MA 02481-1706

Mailing address

1 Washington St Ste 302
Wellesley, MA 02481-1706
Phone (404) 667-5646

Other identifiers 1

IdentifierTypeStateIssuer
00819085MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200922002466 MA Practitioner - Anesthesiology 1658371208 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Current Accepting new patients
Lowell Anesthesia Associates PLLC CurrentSince Feb 1, 2021 Accepting new patients
Pioneer Sedation PLLC CurrentSince Jul 20, 2020 Accepting new patients
Medical Circle of America PLLC Anesthesiology CurrentSince Nov 1, 2020 Accepting new patients
Amsurg Mdsine Anesthesia LLC Anesthesiology CurrentSince Jul 20, 2020 Accepting new patients
Premier Anesthesia of New York, P.C. Anesthesiology Past Accepting new patients
Specialty Surgery Center, Inc. Past Accepting new patients
Cataract and Laser Center Associates PC PastSince Nov 1, 2020 Accepting new patients

Locations

1 Berkshire Sq
Ste 110
Adams, MA 01220
Phone (413) 743-9934

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8085

59 Lowes Way
Lowell, MA 01851
Phone (617) 733-4166

3550 Main St
Ste 103
Springfield, MA 01107
Phone (413) 788-9700

55 Saint George Rd
Springfield, MA 01104
Phone (413) 276-4543

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23183/brand/1/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1154402345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST STE 302",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811706",
            "telephone_number": "404-667-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST STE 302",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811706",
            "telephone_number": "404-667-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOS",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "47886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00819085",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.