Individual provider Active NPI

John C. Manley, M.D.

  • Anesthesiology Physician
  • Waterbury, CT
National Provider Identifier
1447234802
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
029933 Issued in CT
Practice address
1312 W Main St
Waterbury, CT 06708-3121
Phone
(203) 756-6422
Fax
(203) 756-2448
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 029933 CT Primary

Addresses

Primary practice location

1312 W Main St
Waterbury, CT 06708-3121

Mailing address

10 Commerce Dr
New Rochelle, NY 10801-5214
Phone (914) 637-3510

Other identifiers 1

IdentifierTypeStateIssuer
02727388MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050923000423 CT Practitioner - Anesthesiology 6204728777 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029933CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC CurrentSince Oct 1, 2017 Accepting new patients
North American Partners in Anesthesia Connecticut PC Anesthesiology CurrentSince Aug 1, 2017 Accepting new patients
Resource Anesthesiology Associates of CT PC Anesthesiology CurrentSince Jan 1, 2005 Accepting new patients

Locations

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

1312 W Main St
Waterbury, CT 06708
Phone (203) 709-4575

539 Danbury Rd
Wilton, CT 06897
Phone (203) 834-7700

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1447234802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COMMERCE DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015214",
            "telephone_number": "914-637-3510",
            "fax_number": "914-819-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083121",
            "telephone_number": "203-756-6422",
            "fax_number": "203-756-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "JOHN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "029933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02727388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.