Active NPI
Bettina Manduca
- Internal Medicine Physician
- Jackson Heights, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 285737
- Practice address
- 3722 82ND St
2ND Floor
Jackson Heights, NY 11372-7032 - Phone
- (347) 756-0997
- NPI assigned
- Jun 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 285737 | NY | Primary |
Addresses
Primary practice location
3722 82ND St
2ND Floor
Jackson Heights, NY 11372-7032
Mailing address
3722 82ND St
2ND Floor
Jackson Heights, NY 11372-7032
Phone (347) 756-0997
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3722 82ND St
Jackson Heights, NY 11372-7040
Phone (718) 879-1600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 285737 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Medical Group of the Mount Sinai School of Medicine | Internal Medicine | Current | Accepting new patients |
| North Shore Medical Group of the Mount Sinai School of Medicine | Internal Medicine | Current | Accepting new patients |
Locations
3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600
3722 82nd St
Jackson Hts, NY 11372
Phone (718) 779-1600
9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Greenlawn, NY
- NPI 1275640609
-
- Internal Medicine Physician
- Wantagh, NY
- NPI 1992417323
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Brooklyn, NY
- NPI 1770513145
-
- General Acute Care Hospital
- Long Island City, NY
- NPI 1245248939
-
- Rehabilitation Hospital
- New York, NY
- NPI 1669440327
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- General Acute Care Hospital
- New York, NY
- NPI 1225295512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1538573779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3722 82ND ST",
"address_2": "2ND FLOOR",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727032",
"telephone_number": "347-756-0997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3722 82ND ST",
"address_2": "2ND FLOOR",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727032",
"telephone_number": "347-756-0997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDUCA",
"first_name": "BETTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-16",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "285737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.