Marie Anne Mancuso, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

402366 Issued in NY

Practice address

20514 Linden Blvd
Suite 204
Saint Albans, NY 11412-2900

Phone

(718) 528-5493

NPI assigned

Feb 28, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmancuso3999891@nychhc.direct-ci.com
• Direct secure messaging: marie.anne.mancuso.1@32021.direct.athenahealth.com

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.

• Team Care Medical PLLC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1093531691

  NY

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY, Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1245570282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E 3RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181406",
            "telephone_number": "347-756-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20514 LINDEN BLVD",
            "address_2": "SUITE 204",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122900",
            "telephone_number": "718-528-5493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Cadman Plz W Fl 17",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112013229",
            "country_code": "US",
            "telephone_number": "718-822-1818",
            "fax_number": "347-916-1906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "MARIE ANNE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "659896",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macedonia Support Network, Inc.
• Barbara Magloire
• Reeana Mahabir, M.S. ED.
• Maintain Health With Purpose NP in Family Health, PLLC
• Nadesha Maitland
• Rohini Ananda Maragh, NMD
• Amber Marie, LMSW
• Erika Marsh, RN
• Keayna Martin
• Seena Kuriakose Mathew, M S OTR L

• All providers in Saint Albans, NY
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.

Verify at the official NPI Registry.