Active NPI
Angela K Moran Manzitto, PA
- Medical Physician Assistant
- Lincoln, NE
National Provider Identifier
1447438353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1371
- Practice address
- 2200 S 40TH St
Suite 104
Lincoln, NE 68506-2425 - Phone
- (402) 483-6000
- Fax
- (402) 483-6106
- NPI assigned
- Feb 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1371 | NE | Primary |
| Surgical Physician Assistant | 363AS0400X | 1371 | NE |
Addresses
Primary practice location
2200 S 40TH St
Suite 104
Lincoln, NE 68506-2425
Mailing address
8055 O St
Suite 300
Lincoln, NE 68510-2564
Phone (402) 421-0904
Other names 1
- Miss Angela K Moran
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1371 | NE | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Physician Network LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Urgent Care Clinic/Center
- Lincoln, NE
- NPI 1902116833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235347200000",
"number": "1447438353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8055 O ST",
"address_2": "SUITE 300",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102564",
"telephone_number": "402-421-0904",
"fax_number": "402-421-0946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 S 40TH ST",
"address_2": "SUITE 104",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062425",
"telephone_number": "402-483-6000",
"fax_number": "402-483-6106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN MANZITTO",
"first_name": "ANGELA",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-01",
"last_updated": "2009-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NE",
"license": "1371",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NE",
"license": "1371",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "MORAN",
"middle_name": "K",
"prefix": "MISS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.