Active NPI
Lorenzo Mannelli, M.D., PH.D.
- Diagnostic Radiology Physician
- Seattle, WA
National Provider Identifier
1174858138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 25MA09938700
- Practice address
- 1959 NE Pacific Street
Box 357115
Seattle, WA 98195-7115 - Phone
- (646) 226-5924
- NPI assigned
- Oct 8, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 25MA09938700 | NJ | Primary |
Addresses
Primary practice location
1959 NE Pacific Street
Box 357115
Seattle, WA 98195-7115
Mailing address
22 Llanfair Rd Unit 6
Ardmore, PA 19003-2320
Phone (107) 856-3276
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
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09938700 | NJ | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Wood Johnson Medical Associates | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Hospitalist Physician
- New Brunswick, NJ
- NPI 1902848625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596153600000",
"number": "1174858138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 LLANFAIR RD UNIT 6",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032320",
"telephone_number": "107-856-3276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC STREET",
"address_2": "BOX 357115",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981957115",
"telephone_number": "646-226-5924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNELLI",
"first_name": "LORENZO",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-08",
"last_updated": "2020-07-31",
"certification_date": "2020-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NJ",
"license": "25MA09938700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.