Manzanita Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MANZANITA MEDICAL PLLC

Practice address

4545 E Shea Blvd Ste 130
Phoenix, AZ 85028-3061

Phone

(480) 292-9532

Fax

(480) 664-3482

NPI assigned

Jun 19, 2017

Last updated

Jul 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judith Hallas

Title

Office Manager

Phone

(480) 292-9532

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mayy Shaaban Deadrick, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1194741074
  Medicare reassignment Care Compare group NPD
• Shayna M Mansfield, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1780687087
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1306376611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 E SHEA BLVD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283061",
            "telephone_number": "480-292-9532",
            "fax_number": "480-664-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E SHEA BLVD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283061",
            "telephone_number": "480-292-9532",
            "fax_number": "480-664-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANZANITA MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2024-07-23",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "HALLAS",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-292-9532"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Alafriz MD PC
• David Ray Manuel, ATC/LAT
• Samuel Lamar Manuel
• Allison Elizabeth Manweiler, PA-C
• Lindsey N Manz, RD
• Dale Ann Manzoeillo, NP
• Khalid Manzoul, MD
• Lucinda Mapalo
• Briane Jeniene Mape, DNP, FNP-BC
• Jamie Mapes, RN

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.