NPIMap

Individual provider Active NPI

Victor A Manzella, MD

  • Internal Medicine Physician
  • Jim Thorpe, PA
National Provider Identifier
1205810876
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD063778L Issued in PA
Practice address
1353 State Route 903
Jim Thorpe, PA 18229-2734
Phone
(570) 325-8393
Fax
(570) 325-8029
NPI assigned
Dec 6, 2005
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD063778L PA Primary

Addresses

Primary practice location

1353 State Route 903
Jim Thorpe, PA 18229-2734

Mailing address

1605 N Cedar Crest Blvd Ste 110B
Allentown, PA 18104-2351
Phone (610) 973-1410

Other practice location 1

241 Delaware Ave
Palmerton, PA 18071-1812
Phone (610) 826-2909

Other identifiers 10

IdentifierTypeStateIssuer
010044500OtherBLACK LUNG
2598929OtherGHI
5389099OtherAETNA
P00416365OtherPALMETTO GBA GROUP
0444184000OtherPERSONAL BLUE SHIELD
1753980OtherFEDERAL BLUE SHIELD
034162OtherAMERIHEALTH ADMIN
03180401OtherCAPITAL BLUE CROSS
034162OtherPABLUE SHIELD
20031256OtherAMERIHEALTH MERCY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050311000117 PA Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Emergency Medicine 4486608577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine, Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1353 State Route 903
Jim Thorpe, PA 18229-2734
Phone (570) 325-8393

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

241 Delaware Ave
Palmerton, PA 18071-1812
Phone (610) 826-2909

281 N 12TH St
LVPG Vascular Surgery
Lehighton, PA 18235-1101
Phone (610) 402-9400

281 N 12TH St B
Lehighton, PA 18235-1101
Phone (610) 377-7793

281 N 12TH St F
LVPG Obstetrics and Gynecology
Lehighton, PA 18235-1101
Phone (610) 377-5959

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Physician Group Inc Internal Medicine CurrentSince Nov 11, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince May 1, 2023 Accepting new patients
Lehigh Valley Physician Group Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
Regents of the University of California - Ucsd Medical Group Past Accepting new patients

Locations

1605 N Cedar Crest Blvd
Ste 110B
Allentown, PA 18104
Phone (610) 973-1410

2100 Mack Blvd
Fl 4
Allentown, PA 18103

4815 W Tilghman St
Allentown, PA 18104
Phone (610) 402-3903

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1353 State Route 903
Jim Thorpe, PA 18229
Phone (570) 325-8367

211 N 12th St
Lehighton, PA 18235
Phone (610) 377-1300

281 N 12th St
Ste B
Lehighton, PA 18235
Phone (610) 377-7793

135 Lafayette Ave
Palmerton, PA 18071
Phone (610) 826-1103

241 Delaware Ave
Palmerton, PA 18071
Phone (610) 824-6339

120 Pine St
Tamaqua, PA 18252
Phone (570) 645-1540

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15381/brand/1/csg/1/fhir/r4
  • Direct secure messaging: victor.manzellamd.p1@direct.secureehr.nextgenshare.com

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1205810876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351",
            "telephone_number": "610-973-1410",
            "fax_number": "610-973-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 STATE ROUTE 903",
            "city": "JIM THORPE",
            "state": "PA",
            "postal_code": "182292734",
            "telephone_number": "570-325-8393",
            "fax_number": "570-325-8029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 Delaware Ave",
            "address_purpose": "LOCATION",
            "city": "Palmerton",
            "state": "PA",
            "postal_code": "180711812",
            "country_code": "US",
            "telephone_number": "610-826-2909",
            "fax_number": "610-826-7659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZELLA",
        "first_name": "VICTOR",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD063778L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "010044500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2598929",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5389099",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA  GROUP",
            "identifier": "P00416365",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL BLUE SHIELD",
            "identifier": "0444184000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE SHIELD",
            "identifier": "1753980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMIN",
            "identifier": "034162",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03180401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "034162",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20031256",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jim Thorpe, PA

Sources for this page

Verify at the official NPI Registry.