Active NPI
Kevin Mangan
- Audiologist
- Slingerlands, NY
National Provider Identifier
1164530002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 001613
- Practice address
- 1240 New Scotland Road
Speech Pathology and Audiology Department
Slingerlands, NY 12159 - Phone
- (518) 475-7073
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4570 | MA | |
| Audiologist | 231H00000X | 001613 | NY | Primary |
Addresses
Primary practice location
1240 New Scotland Road
Speech Pathology and Audiology Department
Slingerlands, NY 12159
Mailing address
PO Box 14890
Albany, NY 12212-4890
Other practice location 1
510 North St
Suite One
Pittsfield, MA 01201-4111
Phone (413) 448-8291
Other practice location 2
315 So Manning Blvd
Rehabilitation Center
Albany, NY 12208
Phone (518) 475-1818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4570 | MA | MD | Optometrist |
| 001613 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1164530002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14890",
"city": "ALBANY",
"state": "NY",
"postal_code": "122124890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 NEW SCOTLAND ROAD",
"address_2": "SPEECH PATHOLOGY AND AUDIOLOGY DEPARTMENT",
"city": "SLINGERLANDS",
"state": "NY",
"postal_code": "12159",
"telephone_number": "518-475-7073"
}
],
"practiceLocations": [
{
"address_1": "510 North St",
"address_2": "Suite One",
"address_purpose": "LOCATION",
"city": "Pittsfield",
"state": "MA",
"postal_code": "012014111",
"country_code": "US",
"telephone_number": "413-448-8291",
"fax_number": "413-447-9040",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "315 So Manning Blvd",
"address_2": "Rehabilitation Center",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "12208",
"country_code": "US",
"telephone_number": "518-475-1818",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANGAN",
"first_name": "KEVIN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MA",
"license": "4570",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "001613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slingerlands, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.