Individual provider Active NPI

Juan Miguel Mazara

  • Physician Assistant
  • Manchester, NH
National Provider Identifier
1467113977
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1260 Elm St
Manchester, NH 03101-1305
Phone
(978) 387-6881
NPI assigned
Jan 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1260 Elm St
Manchester, NH 03101-1305

Mailing address

1260 Elm St
Manchester, NH 03101-1305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20250423000159 NH Practitioner - Physician Assistant 4183149164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

Practice addresses (Care Compare)

100 McGregor St
Manchester, NH 03102-3730
Phone (603) 665-5150

330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-7112
Phone (603) 431-5242

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group, Inc CurrentSince Apr 7, 2025 Accepting new patients

Locations

100 McGregor St
#B
Manchester, NH 03102
Phone (603) 663-6431

100 McGregor St
Ste B600A
Manchester, NH 03102
Phone (603) 626-2340

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 107
Portsmouth, NH 03801
Phone (603) 433-8434

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: juan.mazara@hca6.eclinicaldirectplus.com

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1467113977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 ELM ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 ELM ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011305",
            "telephone_number": "978-387-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZARA",
        "first_name": "JUAN",
        "middle_name": "MIGUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.