Active NPI
Mary Margaret Manzella
- Nurse Practitioner
- Seffner, FL
National Provider Identifier
1295345676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN11005886
- Practice address
- 704 W Dr Martin Luther King Jr Blvd
Seffner, FL 33584-4534 - Phone
- (813) 681-4431
- NPI assigned
- Jul 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN11005886 | FL | Primary |
Addresses
Primary practice location
704 W Dr Martin Luther King Jr Blvd
Seffner, FL 33584-4534
Mailing address
16616 Palm Royal Dr Apt 615
Tampa, FL 33647-2652
Other practice location 1
2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XHBJS | Other | FL | BLUE CROSS BLUE SHIELD |
| 108417000 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmanzella251547@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
16616 Palm Royal Dr
Apt 615
Tampa, FL 33647-2652
Minuteclinic Payer Enrollment
Woonsocket, RI 02895-0784
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Service Association Inc | Current | Accepting new patients | |
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Past | Accepting new patients |
Locations
2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700
Networks
- Freedom Health HMO Network
Interoperability endpoints
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
- mmanzella251547@direct.tgh.org
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- Neurological Surgery Physician
- Tampa, FL
- NPI 1740227966
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Tampa General Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1235196510
-
dba St. Joseph's Women's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1295345676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16616 PALM ROYAL DR APT 615",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 W DR MARTIN LUTHER KING JR BLVD",
"city": "SEFFNER",
"state": "FL",
"postal_code": "335844534",
"telephone_number": "813-681-4431"
}
],
"practiceLocations": [
{
"address_1": "2 Tampa General Cir",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336063571",
"country_code": "US",
"telephone_number": "813-821-8038",
"fax_number": "813-974-4325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANZELLA",
"first_name": "MARY",
"middle_name": "MARGARET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-31",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN11005886",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "XHBJS",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108417000",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmanzella251547@direct.tgh.org",
"affiliation": "N",
"address_1": "2 Tampa General Cir",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336063571",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seffner, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.