Individual provider Active NPI

Tanya L Manning, PA-C

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1548244882
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005496 Issued in CO
Practice address
4451 Bayou Blvd
Pensacola, FL 32503
Phone
(850) 416-7753
NPI assigned
Nov 30, 2005
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9108853 FL
Physician Assistant 363A00000X PA.0005496 CO Primary

Addresses

Primary practice location

4451 Bayou Blvd
Pensacola, FL 32503

Mailing address

1158 Rockridge St
Mountain Home, ID 83647-3564
Phone (208) 587-4057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO, GU3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180119000348 FL Practitioner - Physician Assistant 3274892229 Reassigns benefits to 1 organization
I20180919002538 CO Practitioner - Physician Assistant 3274892229 Reassigns benefits to 1 organization
I20240508002268 GU Practitioner - Physician Assistant 3274892229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guam Dermatology Institute LLCGroup PAC ID 7012341456, 3 clinicians

Practice addresses (Care Compare)

633 Gov Carlos G Camacho Rd
Suite 102
Tamuning, GU 96913-3143
Phone (671) 588-5001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0005496COMDPhysician Assistant
PA9108853FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Jan 14, 2018 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Jan 14, 2018 Accepting new patients

Locations

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1548244882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 ROCKRIDGE ST",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473564",
            "telephone_number": "208-587-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32503",
            "telephone_number": "850-416-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "TANYA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108853",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.