Active NPI
Jon Maniaci, M.D.
- Pediatric Pulmonology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- MT220827
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT220827 | PA | MD | Pediatric Pulmonology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childen'S Health Care Associates Inc. | Current | Accepting new patients | |
| Children'S Healthcare Associates of New Jersey, PC | Current | Accepting new patients | |
| Childens Health Care Associates of New Jersey PC | Current | 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 | Current | 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
- 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.
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1598869059
-
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
-
- Pediatric Registered Nurse
- Philadelphia, PA
- NPI 1699860643
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1083709042
-
- Pediatric Emergency Medicine (Pediatrics) Physician
- Voorhees, NJ
- NPI 1467547471
-
- Neonatal-Perinatal Medicine Physician
- Plainsboro, NJ
- NPI 1194964593
-
- Neonatal-Perinatal Medicine Physician
- Philadelphia, PA
- NPI 1417042466
-
- Children's Hospital
- Philadelphia, PA
- NPI 1215921457
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.