Individual provider Active NPI

John V Mangieri, MD

  • Orthopaedic Surgery Physician
  • Trumbull, CT
National Provider Identifier
1386726768
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
013045 Issued in CT
Practice address
160 Hawley Lane
Trumbull, CT 06611
Phone
(203) 381-9670
Fax
(203) 381-9669
NPI assigned
Oct 19, 2006
Last updated
Feb 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 013045 CT Primary

Addresses

Primary practice location

160 Hawley Lane
Trumbull, CT 06611

Mailing address

160 Hawley Lane
Trumbull, CT 06611
Phone (203) 381-9670

Other identifiers 1

IdentifierTypeStateIssuer
001130459MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013045CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1386726768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HAWLEY LANE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "06611",
            "telephone_number": "203-381-9670",
            "fax_number": "203-381-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HAWLEY LANE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "06611",
            "telephone_number": "203-381-9670",
            "fax_number": "203-381-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIERI",
        "first_name": "JOHN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "013045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001130459",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.