Olivia E. Mancilla, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

018327-1 Issued in NY

Practice address

760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206

Phone

(718) 963-8000

Fax

(718) 630-3122

NPI assigned

Jan 29, 2015

Last updated

Jan 29, 2015By the provider in NPPES

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: omancilla563639@nychhc.direct-ci.com

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.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment NPD

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1467842427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 LAWRENCE AVENUE",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "11096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCILLA",
        "first_name": "OLIVIA",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "018327-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Mancher, M.S.
• Cameron Manchester, MD
• Devasena Manchikalapati, MD
• Nikhila Manchikanti, NP
• Lee Manchio, DO
• Erica Mancinelli
• Crescenza Mancini, M.S. SPEECH
• Josephine Mancini
• Victoria Mancini
• Isabella Mancino, DO

• Medical Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.