Individual provider Active NPI

Lucinda Grace Manges, C.N.M

  • Advanced Practice Midwife
  • Ephrata, PA
National Provider Identifier
1417215278
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MW010274 Issued in PA
Practice address
175 Martin Ave
Suite 125
Ephrata, PA 17522-1761
Phone
(717) 721-5700
Fax
(717) 721-5712
NPI assigned
Apr 30, 2012
Last updated
Jul 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X MW010274 PA Primary

Addresses

Primary practice location

175 Martin Ave
Suite 125
Ephrata, PA 17522-1761

Mailing address

175 Martin Ave
Suite 125
Ephrata, PA 17522-1761
Phone (717) 721-5700

Other identifiers 1

IdentifierTypeStateIssuer
240573UFWOtherPAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000412 PA Practitioner - Certified Nurse Midwife (CNM) 6204090798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

175 Martin Ave
Suite 320
Ephrata, PA 17522-1761
Phone (717) 721-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
MW010274PAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Aug 19, 2019 Accepting new patients
Midwives of Lebanon Valley Advanced Practice Midwife Current Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Aug 19, 2019 Accepting new patients

Locations

175 Martin Ave
Ste 125
Ephrata, PA 17522
Phone (717) 812-4602

175 Martin Ave
Ste 320
Ephrata, PA 17522
Phone (717) 721-5800

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: lmanges73449@wellspan.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1417215278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MARTIN AVE",
            "address_2": "SUITE 125",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221761",
            "telephone_number": "717-721-5700",
            "fax_number": "717-721-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MARTIN AVE",
            "address_2": "SUITE 125",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221761",
            "telephone_number": "717-721-5700",
            "fax_number": "717-721-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGES",
        "first_name": "LUCINDA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "C.N.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "240573UFW",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.