Individual provider Active NPI

James A Manzella, LCSW

  • Clinical Social Worker
  • Pittsburgh, PA
National Provider Identifier
1225110430
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014687 Issued in PA
Practice address
2250 Mary St
Suite 307
Pittsburgh, PA 15203-2280
Phone
(412) 488-8102
Fax
(412) 488-0166
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW014687 PA Primary

Addresses

Primary practice location

2250 Mary St
Suite 307
Pittsburgh, PA 15203-2280

Mailing address

2250 Mary St
Suite 309
Pittsburgh, PA 15203-2280
Phone (412) 488-8102

Other identifiers 1

IdentifierTypeStateIssuer
348865OtherPAHIGHMARK PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000669 PA Practitioner - Clinical Social Worker 2668433947 Practice locations: Pittsburgh, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2250 Mary St
Pittsburgh, PA 15203-2290
Phone (412) 488-8102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Persad Center, Inc. PastSince Aug 15, 2014 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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1225110430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 MARY ST",
            "address_2": "SUITE 309",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032280",
            "telephone_number": "412-488-8102",
            "fax_number": "412-488-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 MARY ST",
            "address_2": "SUITE 307",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032280",
            "telephone_number": "412-488-8102",
            "fax_number": "412-488-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZELLA",
        "first_name": "JAMES",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PIN",
            "identifier": "348865",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.