Organization Active NPI

Wilbert B. Maniego, M.D., P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • New Hyde Park, NY
National Provider Identifier
1295032753
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
221557-1 Issued in NY
Legal business name
WILBERT B. MANIEGO, M.D., P.C.
Practice address
915 Hillside Ave
New Hyde Park, NY 11040-2529
Phone
(718) 343-7600
Fax
(718) 343-7603
NPI assigned
Feb 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Dr. Wilbert B Maniego, M.D.NPI 1356392427
Title
President/Physician
Phone
(718) 343-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 221557 NY
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X 221557-1 NY Primary

Addresses

Primary practice location

915 Hillside Ave
New Hyde Park, NY 11040-2529

Mailing address

915 Hillside Ave
New Hyde Park, NY 11040-2529
Phone (718) 343-7600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120315000166 NY Part B Supplier - Clinic/Group Practice 1456510171 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1295032753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HILLSIDE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402529",
            "telephone_number": "718-343-7600",
            "fax_number": "718-343-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HILLSIDE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402529",
            "telephone_number": "718-343-7600",
            "fax_number": "718-343-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILBERT B. MANIEGO, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "MANIEGO",
        "authorized_official_first_name": "WILBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "718-343-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221557",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "221557-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.