Individual provider Active NPI

Jon Maniaci, M.D.

  • Pediatric Pulmonology Physician
  • Philadelphia, PA
National Provider Identifier
1225560832
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
MT220827 Issued in PA
Practice address
3401 Civic Center Blvd
Division of Pediatric Pulmonology
Philadelphia, PA 19104
Phone
(267) 425-2959
NPI assigned
Apr 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Pulmonology Physician 2080P0214X MT220827 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Division of Pediatric Pulmonology
Philadelphia, PA 19104

Mailing address

3401 Civic Center Blvd
Division of Pediatric Pulmonology
Philadelphia, PA 19104
Phone (267) 425-2959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250410002319 PA Practitioner - Pulmonary Disease 6002330123 Reassigns benefits to 1 organization
I20250410002682 NJ Practitioner - Pulmonary Disease 6002330123 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT220827PAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince Feb 2, 2025 Accepting new patients
Children'S Healthcare Associates of New Jersey, PC CurrentSince Feb 2, 2025 Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Feb 2, 2025 Accepting new patients
Childrens Health Care Associates of New Jersey PC Current Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Children'S Health Care Associates CurrentSince Feb 2, 2025 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Childrens Health Care Associates, Inc Past Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

200 Bowman Dr
Voorhees, NJ 08043
Phone (267) 425-5400

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Interoperability endpoints

  • Direct secure messaging: jmaniaci28187@direct.vumc.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1225560832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC PULMONOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "267-425-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC PULMONOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "267-425-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIACI",
        "first_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-02",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MT220827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.