Active NPI
Jack Michael Mann, M.D.
- Pulmonary Disease Physician
- Bayside, NY
National Provider Identifier
1376542217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 158742
- Practice address
- 42-23 Francis Lewis Blvd.
Ste. 105
Bayside, NY 11361 - Phone
- (718) 225-5106
- Fax
- (718) 225-0816
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 158742 | NY | Primary |
Addresses
Primary practice location
42-23 Francis Lewis Blvd.
Ste. 105
Bayside, NY 11361
Mailing address
42-23 Francis Lewis Blvd.
Ste. 105
Bayside, NY 11361
Phone (718) 225-5106
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00923579 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4223 Francis Lewis Blvd
Suite 105
Bayside, NY 11361-2580
Phone (718) 225-5106
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 23.18 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 77.27
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Queens Medicine and Surgery, P.C. | Current | Accepting new patients | |
| New York Queens Medicine and Surgery, P.C. | Current | Accepting new patients | |
| Heart and Lung Associates, PC | Pulmonary Disease | Current | Accepting new patients |
| Ny Pelvic Pain and Minimally Invasive Gynecologic Surgery PC | Past | Accepting new patients | |
| Doctor Medical of Ny PC | Past | Accepting new patients |
Locations
4223 Francis Lewis Blvd
Ste 105
Bayside, NY 11361
Phone (718) 225-5106
16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121
354 Fort Washington Ave
New York, NY 10033
Phone (212) 781-0100
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Interoperability endpoints
- jmm9015@direct.nyp.org
Organizations & group practices 5
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.
-
- Pulmonary Disease Physician
- Bayside, NY
- NPI 1053399006
-
- Pediatrics Physician
- Fresh Meadows, NY
- NPI 1003114851
-
- Multi-Specialty Clinic/Center
- Flushing, NY
- NPI 1740792233
-
- Family Medicine Physician
- Bronx, NY
- NPI 1831140722
-
- Gynecology Physician
- New York, NY
- NPI 1710022140
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Flushing, NY
- NPI 1952347205
-
- Community Based Hospice Care Agency
- New York, NY
- NPI 1215928510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586390400000",
"number": "1376542217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42-23 FRANCIS LEWIS BLVD.",
"address_2": "STE. 105",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11361",
"telephone_number": "718-225-5106",
"fax_number": "718-225-0816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42-23 FRANCIS LEWIS BLVD.",
"address_2": "STE. 105",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11361",
"telephone_number": "718-225-5106",
"fax_number": "718-225-0816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "JACK",
"middle_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2020-04-09",
"certification_date": "2020-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "158742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00923579",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.