Tyler Mannino, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017597 Issued in NY

Practice address

1512 Broadway
Hewlett, NY 11557-1429

Phone

(516) 374-6838

Fax

(516) 374-2362

NPI assigned

Jul 2, 2014

Sex

Male

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Village Medical, P.C.Group PAC ID 8325050883, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Village Medical, P.C.

  • Orthopaedic Hand Surgery Physician
  • Smithtown, NY
  • NPI 1598718272
  Medicare reassignment Care Compare group
• Island Musculoskeletal Care MD PC

  • Orthopaedic Surgery Physician
  • Hewlett, NY
  • NPI 1063524197
  Medicare reassignment

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1487060158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571429",
            "telephone_number": "516-374-6838",
            "fax_number": "516-374-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571429",
            "telephone_number": "516-374-6838",
            "fax_number": "516-374-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "TYLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long Island Radiology Associates, PC
• Long Island Spine Chiropractic PLLC
• Elana Lubianker, PA
• Barbara C Mandell, MD
• Esther Mann, L.C.S.W.
• Carline Marcellus, LDO
• Marcy H Zingman
• Ronald Margolies, D.M.D.
• Alan Roland Markowitz, MD
• Richard Louis Markowitz, MD

• Physician Assistant in Hewlett, NY
• Providers in Hewlett, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.