Individual provider Active NPI

Gregory Raymond Mannarelli II, AU.D.

  • Audiologist
  • Ann Arbor, MI
National Provider Identifier
1285882217
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
16010000110 Issued in MI
Practice address
1500 East Medical Center Drive
1St Floor Taubman Center Recp a
Ann Arbor, MI 48109-5312
Phone
(734) 936-8051
Fax
(734) 936-8052
NPI assigned
Sep 3, 2008
Last updated
Nov 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 16010000110 MI Primary

Addresses

Primary practice location

1500 East Medical Center Drive
1St Floor Taubman Center Recp a
Ann Arbor, MI 48109-5312

Mailing address

3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140213000469 MI Practitioner - Qualified Audiologist 3870722960 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16010000110MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Audiologist CurrentSince Nov 5, 2013 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Audiologist CurrentSince Nov 5, 2013 Accepting new patients
Regents of the University of Michigan CurrentSince Nov 5, 2013 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Fl 1
Ann Arbor, MI 48109
Phone (734) 936-4054

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3621 S State St
#700
Ann Arbor, MI 48108

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1285882217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DRIVE",
            "address_2": "1ST FLOOR TAUBMAN CENTER RECP A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095312",
            "telephone_number": "734-936-8051",
            "fax_number": "734-936-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNARELLI",
        "first_name": "GREGORY",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "16010000110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.