Michael Mangonon, D.O.

Primary specialty

Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X

License

72644 Issued in GA

Practice address

4775 Jimmy Carter Blvd Ste 201
Norcross, GA 30093-3760

Phone

(470) 305-0848

Fax

(470) 305-1110

NPI assigned

Jan 7, 2009

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Hand Surgery

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmangonon97506@directwellstar.org

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.

• Hand Trauma and Surgery Specialists LLC

  • Surgery of the Hand (Surgery) Physician
  • Norcross, GA
  • NPI 1114816964
  NPD Authorized official
• Dkumar LLC

  • Surgery of the Hand (Surgery) Physician
  • Smyrna, GA
  • NPI 1639408123
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Ahs Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Smyrna, GA
  • NPI 1316214604
  NPD (past)
• Carpus Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Marietta, GA
  • NPI 1568864452
  NPD (past)
• Ulna Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Johns Creek, GA
  • NPI 1881147965
  NPD (past)

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1609013036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 PEACHTREE PKWY STE D",
            "address_2": "#246",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246008",
            "telephone_number": "470-305-0848",
            "fax_number": "470-305-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD STE 201",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "470-305-0848",
            "fax_number": "470-305-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGONON",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-07",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "GA",
            "license": "72644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerin Jahan Malik
• Maloms Group International, LLC.
• Donna Maloney
• Managed Health Solutions LLC
• Aaron Thien Tuong Manela, DDS
• Deonna Mapp
• Susan Christine Margletta, MD
• Marie C. Schweinebraten, Dmdpc
• Michael Vily Markovich, PT, DPT
• Lawrence Matthew Marra, DDS

• Surgery of the Hand (Surgery) Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Surgery of the Hand (Surgery) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2025; 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.