Individual provider Active NPI

Evelyn Cimafrance Maningo, MD

  • Internal Medicine Physician
  • Valrico, FL
National Provider Identifier
1205859592
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME66858 Issued in FL
Practice address
2237 Lithia Center LN
Valrico, FL 33596-5676
Phone
(813) 662-0123
Fax
(813) 622-9422
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 ME66858 FL Primary

Addresses

Primary practice location

2237 Lithia Center LN
Valrico, FL 33596-5676

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (813) 754-3344

Other identifiers 1

IdentifierTypeStateIssuer
378000700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050323000276 FL Practitioner - Internal Medicine 3476509456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

621 W Brandon Blvd
Wellmed at Brandon Regional
Brandon, FL 33511-5964
Phone (813) 681-5702

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.76
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Internal Medicine CurrentSince May 1, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince May 1, 2022 Accepting new patients
Wellmed Medical Management of Florida Inc CurrentSince Mar 4, 2024 Accepting new patients

Locations

621 W Brandon Blvd
Brandon, FL 33511
Phone (813) 678-2373

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

1907 S Alexander St
Ste 1
Plant City, FL 33566
Phone (813) 654-8100

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

2237 Lithia Center Ln
Valrico, FL 33596
Phone (813) 662-0123

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: evelyn.maningo@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1205859592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "813-754-3344",
            "fax_number": "813-754-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 LITHIA CENTER LN",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965676",
            "telephone_number": "813-662-0123",
            "fax_number": "813-622-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANINGO",
        "first_name": "EVELYN",
        "middle_name": "CIMAFRANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME66858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378000700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.