NPIMap

Organization Active NPI

Maniscalco Oral and Facial Surgery LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Birmingham, AL
National Provider Identifier
1376271056
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
MANISCALCO ORAL AND FACIAL SURGERY LLC
Practice address
101 Heatherbrooke Park Dr
Birmingham, AL 35242-8008
Phone
(205) 991-9787
NPI assigned
Aug 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Lee Michael Maniscalco, MD, DMDNPI 1821397589
Title
Owner
Phone
(205) 527-3091

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

101 Heatherbrooke Park Dr
Birmingham, AL 35242-8008

Mailing address

101 Heatherbrooke Park Dr
Birmingham, AL 35242-8008
Phone (205) 991-9787

Other names 1

  • Gonzalez, Carr, and Maniscalco Oral and Facial Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220928003083 AL Part B Supplier - Clinic/Group Practice 3375929391 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1376271056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HEATHERBROOKE PARK DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428008",
            "telephone_number": "205-991-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HEATHERBROOKE PARK DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428008",
            "telephone_number": "205-991-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANISCALCO ORAL AND FACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "MANISCALCO",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-527-3091",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gonzalez, Carr, and Maniscalco Oral and Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.