Mammolink LLC

Primary specialty

Mobile Mammography Clinic/CenterTaxonomy code 261QR0207X

Legal business name

MAMMOLINK LLC

Practice address

3982 Woodland Retreat Blvd
New Port Richey, FL 34655-4593

Phone

(844) 546-5871

Fax

(844) 546-5871

NPI assigned

Jul 25, 2019

Last updated

Sep 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Joseph Polselli, MDNPI 1396872263

Title

Owner

Phone

(912) 667-8654

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Interoperability endpoints

• Direct secure messaging: customerservice@mammolink.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Joseph Polselli, M.D.

  • Diagnostic Radiology Physician
  • New Port Richey, FL
  • NPI 1396872263
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1184278483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3982 WOODLAND RETREAT BLVD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346554593",
            "telephone_number": "844-546-5871",
            "fax_number": "844-546-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3982 WOODLAND RETREAT BLVD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346554593",
            "telephone_number": "844-546-5871",
            "fax_number": "844-546-5871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Manor Blvd",
            "address_purpose": "LOCATION",
            "city": "Palm Harbor",
            "state": "FL",
            "postal_code": "346831324",
            "country_code": "US",
            "telephone_number": "844-546-5871",
            "fax_number": "844-546-5871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAMMOLINK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "POLSELLI",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-667-8654",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "customerservice@mammolink.com",
            "affiliation": "N",
            "address_1": "435 Manor Blvd",
            "city": "Palm Harbor",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346831324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "customerservice@mammolink.com",
            "affiliation": "N",
            "address_1": "3982 Woodland Retreat Blvd",
            "city": "New Port Richey",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346554593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shonna Monique Mallard
• Sally Mallery, LMHC
• Malleswari S Vangara MD PA
• Sarah Mallett, MD
• Marc Jeffrey Mallis, MD
• Joseph Michael Mancusi, D.C.
• Hanan Milad Mankarious, PHARMD
• Madison Manke
• William Thomas Manley, APRN
• Haley Mann

• Clinic/Center in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.