Jack Earl Maniscalco, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

ME0023743 Issued in FL

Practice address

2816 W Virginia Ave
Neurological Specialties Neurosurgery PA
Tampa, FL 33607-6330

Phone

(813) 876-6321

Fax

(813) 870-0350

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Neurological Specialties Neurology PA

  • Neurology Physician
  • Tampa, FL
  • NPI 1932167566
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1285682872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 W VIRGINIA AVE",
            "address_2": "NEUROLOGICAL SPECIALTIES NEUROSURGERY PA",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076330",
            "telephone_number": "813-876-6321",
            "fax_number": "813-870-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 W VIRGINIA AVE",
            "address_2": "NEUROLOGICAL SPECIALTIES NEUROSURGERY PA",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076330",
            "telephone_number": "813-876-6321",
            "fax_number": "813-870-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANISCALCO",
        "first_name": "JACK",
        "middle_name": "EARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME0023743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "406143136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "F70917030",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME0023743",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "059512800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "71703",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dion Manhoff, MD
• Rajasekaran Mani
• Manica Health Care, Inc.
• Gordon Michael Maniere, CP
• Manifestations Worldwide Inc
• Valerie Maniscalco
• Maryis Elena Manjarres
• Manjul Derasari M.D.,P.a.
• Manlar, Inc.
• Brandon Manley, M.D.

• Neurological Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.