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Organization Active NPI

Manchester Urology Associates Professional Association

  • Urology Physician
  • Manchester, NH
National Provider Identifier
1578660700
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MANCHESTER UROLOGY ASSOCIATES PROFESSIONAL ASSOCIATION
Practice address
4 Elliot Way
Suite 200
Manchester, NH 03103-3547
Phone
(603) 669-9200
Fax
(603) 624-2210
NPI assigned
Sep 20, 2006
Last updated
Aug 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Authorized official

Name
Ann Gilbert
Title
Practice Manager
Phone
(603) 836-1590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

4 Elliot Way
Suite 200
Manchester, NH 03103-3547

Mailing address

17 Riverside St
Nashua, NH 03062-1304
Phone (603) 836-1562

Other practice location 1

121 Corporate Dr
Portsmouth, NH 03801-0000
Phone (603) 742-1444

Other practice location 2

160 S River Rd
Bedford, NH 03110-6927
Phone (603) 669-9200

Other practice location 3

10 Members Way
Dover, NH 03820-5933
Phone (603) 742-1444

Other practice location 4

17 Riverside St
Nashua, NH 03062-1304
Phone (603) 836-1562

Other practice location 5

14 Tsienneto Rd
Derry, NH 03038-1647
Phone (603) 669-9200

Other identifiers 1

IdentifierTypeStateIssuer
3080714MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051214000467 NH Part B Supplier - Clinic/Group Practice 6406877760 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
Practice locations: Portsmouth, NH; Peterborough, NH; Nashua, NH; Dover, NH; Derry, NH; Bedford, NH; Manchester, NH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

14 Tsienneto Rd
Derry, NH 03038
Phone (603) 425-6966

15 Durham Rd
Ste 210
Dover, NH 03820
Phone (207) 475-0100

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1578660700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 RIVERSIDE ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030621304",
            "telephone_number": "603-836-1562",
            "fax_number": "603-836-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ELLIOT WAY",
            "address_2": "SUITE 200",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033547",
            "telephone_number": "603-669-9200",
            "fax_number": "603-624-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Corporate Dr",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038010000",
            "country_code": "US",
            "telephone_number": "603-742-1444",
            "fax_number": "603-742-1443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 S River Rd",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106927",
            "country_code": "US",
            "telephone_number": "603-669-9200",
            "fax_number": "603-669-9286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Members Way",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038205933",
            "country_code": "US",
            "telephone_number": "603-742-1444",
            "fax_number": "603-742-1443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Riverside St",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030621304",
            "country_code": "US",
            "telephone_number": "603-836-1562",
            "fax_number": "603-836-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381647",
            "country_code": "US",
            "telephone_number": "603-669-9200",
            "fax_number": "603-624-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MANCHESTER UROLOGY ASSOCIATES PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "603-836-1590"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080714",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.