Individual provider Active NPI

Mana Mann, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1356509715
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
251618 Issued in NY
Practice address
1225 Morris Park Ave
Bronx, NY 10461-1929
Phone
(718) 839-7025
Fax
(718) 904-1162
NPI assigned
Jun 1, 2008
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD444196 PA
Developmental - Behavioral Pediatrics Physician 2080P0006X 251618 NY Primary

Addresses

Primary practice location

1225 Morris Park Ave
Bronx, NY 10461-1929

Mailing address

1225 Morris Park Ave
Bronx, NY 10461-1929
Phone (718) 839-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170830003536 NY Practitioner - Pediatric Medicine 2860652112 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 16, 2024 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Jul 14, 2017 Accepting new patients
TJH Medical Services, P.C. Pediatrics CurrentSince Sep 19, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jul 14, 2017 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1225 Morris Park Ave
Bronx, NY 10461
Phone (718) 430-8500

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

300 Community Dr
Manhasset, NY 11030

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

1983 Marcus Ave
Ste 130
New Hyde Park, NY 11042
Phone (516) 802-6100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mmann290572@northwell.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1212278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1356509715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611929",
            "telephone_number": "718-839-7025",
            "fax_number": "718-904-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611929",
            "telephone_number": "718-839-7025",
            "fax_number": "718-904-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "MANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-01",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD444196",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "251618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.