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Individual provider Active NPI

Danny John Mancini, PA-C

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1376862532
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2395 Issued in CT
Practice address
100 Retreat Ave
Suite 705
Hartford, CT 06106-2528
Phone
(860) 278-0070
NPI assigned
May 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2395 CT Primary

Addresses

Primary practice location

100 Retreat Ave
Suite 705
Hartford, CT 06106-2528

Mailing address

100 Retreat Ave
Suite 705
Hartford, CT 06106-2528
Phone (860) 278-0070

Other identifiers 1

IdentifierTypeStateIssuer
003023959MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110316000290 CT Practitioner - Physician Assistant 7517995970 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

2955 Main St
Suite 430
Glastonbury, CT 06033-1092
Phone (860) 650-3848

576 Farmington Ave
Bristol, CT 06010-3933
Phone (860) 650-3848

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-7500

900 Main St S
Suite 100
Southbury, CT 06488-4213
Phone (860) 650-3848

920 Wolcott St
Suite 19
Waterbury, CT 06705-1300
Phone (860) 650-3848

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2395CTMDCounselor
000714CTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Dec 20, 2010 Accepting new patients
Long River Physicians, LLC Past Accepting new patients
Franklin Medical Group, PC Past Accepting new patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

100 Retreat Ave
Ste 705
Hartford, CT 06106
Phone (860) 278-0070

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1376862532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 705",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062528",
            "telephone_number": "860-278-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 705",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062528",
            "telephone_number": "860-278-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCINI",
        "first_name": "DANNY",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "2395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003023959",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.