Mayra Johanna Manchego

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS023848 Issued in PA

Practice address

4262 Old William Penn Hwy Ste 208
Murrysville, PA 15668-1954

Phone

(724) 325-2133

NPI assigned

Apr 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mayra Johanna Manchego Buendia Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mayra@esp.pcc-direct.com

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.

• East Suburban Pediatric Associates LTD

  • Pediatrics Physician
  • Murrysville, PA
  • NPI 1134274277
  NPD (past)

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1316526270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4262 OLD WILLIAM PENN HWY STE 208",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156681954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4262 OLD WILLIAM PENN HWY STE 208",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156681954",
            "telephone_number": "724-325-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHEGO",
        "first_name": "MAYRA",
        "middle_name": "JOHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS023848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYRA",
            "last_name": "MANCHEGO BUENDIA",
            "middle_name": "JOHANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Lu, MD
• Sydney Gober Lucas, LPC-S
• Emily Lunt, LSW
• Laurene L Madine, M.S.W., L.C.S.W.
• Mainline Pharmacy Murrysville, LLC (Mainline Pharmacy Murrysville)
• Jennifer L March, MPT
• Marsalese Chiropractic Offices PC
• Jeffrey K Marsalese, DC, DACBN, CCN
• Loriann M Massarelli, LCSW
• Nicholas Mastovich, DPT

• Pediatrics Physician in Murrysville, PA
• Providers in Murrysville, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.