Individual provider Active NPI

Anthony John Mannina, M.D.

  • Pulmonary Disease Physician
  • Wheat Ridge, CO
National Provider Identifier
1336142694
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
30188 Issued in CO
Practice address
8550 W 38TH Ave
Ste 202
Wheat Ridge, CO 80033-4342
Phone
(303) 940-1661
Fax
(303) 431-8708
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 30188 CO Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 30188 CO

Addresses

Primary practice location

8550 W 38TH Ave
Ste 202
Wheat Ridge, CO 80033-4342

Mailing address

8550 W 38TH Ave
Ste 202
Wheat Ridge, CO 80033-4342
Phone (303) 940-1661

Other identifiers 1

IdentifierTypeStateIssuer
01301886MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000303 CO Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 4587746466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30188COMDSleep Medicine (Internal Medicine) Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1336142694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE",
            "address_2": "STE 202",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334342",
            "telephone_number": "303-940-1661",
            "fax_number": "303-431-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE",
            "address_2": "STE 202",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334342",
            "telephone_number": "303-940-1661",
            "fax_number": "303-431-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINA",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "30188",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CO",
            "license": "30188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01301886",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.