Brian David Mancke, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA10978800 Issued in NJ

Practice address

1402 E County Line Rd
Indianapolis, IN 46227

Phone

(317) 887-7000

NPI assigned

Jun 24, 2009

Last updated

Apr 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Family Practice

Education

New York Medical College, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care, Inc. Home health agency, Egg Harbor Township, NJ, CCN 317066
• Patient Care Home health agency, Egg Harbor Township, NJ, CCN 317072
• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Atlanticare Urgent Care Physicians LLC

  • Urgent Care Clinic/Center
  • Sicklerville, NJ
  • NPI 1083991616
  Medicare reassignment NPD
• Atlanticare Physician Group

  dba AtlantiCare Urgent Care

  • Clinical Social Worker
  • Egg Harbor Township, NJ
  • NPI 1881618494
  NPD
• Atlanticare Physician Group, PA

  dba AtlantiCare Urgent Care

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD
• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Egg Harbor Township, NJ
  • NPI 1922820901
  Care Compare affiliation
• LHCG CXLV, LLC

  dba AtlantiCare Home Health

  • Home Health Agency
  • Egg Harbor Township, NJ
  • NPI 1154884401
  Care Compare affiliation

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1336377712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE.",
            "address_2": "BLDG 900 SUITE 909",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "08234",
            "telephone_number": "609-407-2380",
            "fax_number": "609-677-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46227",
            "telephone_number": "317-887-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Parklawn Dr",
            "address_2": "Midwest Regional Medical Center Emergency Room",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731104201",
            "country_code": "US",
            "telephone_number": "405-610-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCKE",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD444818",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "29995",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10978800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eilabeth Manalo
• John Jacob Manaloor, M.D.
• Andrea Manchak
• Naveen Manchanda, MD
• Shalini K Manchanda, MD
• Gilford Manco
• Pooja Naginroy Mandalia, DDS
• Terry Jay Mandel, DO
• Mandelbaum Surgical PC (Indy Southside Surgical)
• Jonathan A Mandelbaum, MD

• Family Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.

Verify at the official NPI Registry.