Jillian Anne Mancuso, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

019737 Issued in NY

Practice address

43 New Scotland Ave
Albany, NY 12208-3478

Phone

(518) 262-1139

NPI assigned

Jul 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Physician Assistant

  Medicare reassignment NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248

  Physician Assistant

  NPD

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1396197463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083478",
            "telephone_number": "518-577-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083478",
            "telephone_number": "518-262-1139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Route 146",
            "address_2": "Cardiology",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "12065",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Palisades Dr",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122051438",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "JILLIAN",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadezda Mamedova
• Luke Mammen
• Keren Rae Dumaslan Manacop, CRNA
• Lisa Marie Manasier, LCSW
• Diana Maria Mancini, LMSW
• Mia L Mancuso, PHARMD
• Amrutha Chandra Mandava, D.M.D.
• Blaire Manderville, RN
• Archana Mane, M.D.
• Shamee Paresh Mane, M.D.

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.