Individual provider Active NPI

Matthew Stephen Manganaro, M.D.

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1609118710
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
339293 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-9055
NPI assigned
Mar 27, 2013
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 65173 MN
Diagnostic Radiology Physician 2085R0202X 339293 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

5402 Fort Hamilton Pkwy
FL 6
Brooklyn, NY 11219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240819003188 MI Practitioner - Diagnostic Radiology 9234431321 Reassigns benefits to 2 organizations
I20260214000342 NY Practitioner - Diagnostic Radiology 9234431321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York at Buffalo School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshfield Clinic IncGroup PAC ID 2264345206, 207 clinicians
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians
Radiologists of Univ of RochesterGroup PAC ID 6800700170, 140 clinicians

Practice addresses (Care Compare)

Troy, MI 48084
Phone (800) 782-8581

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
339293NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 15, 2019 Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2019 Accepting new patients
Altru Health System CurrentSince Aug 1, 2019 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Dec 9, 2025 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Altru Health System CurrentSince Aug 1, 2019 Accepting new patients
Towner County Medical Center Inc CurrentSince Aug 1, 2019 Accepting new patients
Lac Qui Parle Clinic of Madison Inc CurrentSince Dec 20, 2023 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Mar 1, 2025 Accepting new patients
The Duluth Clinic, LTD. CurrentSince May 21, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Fairview Clinics Current Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2019 Accepting new patients
Fairview Clinics CurrentSince Sep 29, 2021 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Pembina County Memorial Hospital Association CurrentSince Aug 1, 2019 Accepting new patients
Suburban Imaging, LLC CurrentSince Feb 1, 2020 Accepting new patients
Allina Health System Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Tria Orthopaedic Center LLC Diagnostic Radiology CurrentSince Sep 21, 2022 Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Allina Health System Current Accepting new patients
Fairview Clinics CurrentSince Sep 29, 2021 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Mar 1, 2025 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Jan 13, 2023 Accepting new patients
Range Regional Health Services CurrentSince Apr 1, 2025 Accepting new patients
Allina Health System CurrentSince Aug 1, 2019 Accepting new patients
Fairview Express Care CurrentSince May 1, 2021 Accepting new patients
P R Health Corporation Current Accepting new patients
Lutheran Charity Association Diagnostic Radiology CurrentSince Oct 7, 2024 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Ridgeview Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Range Regional Health Services CurrentSince Apr 1, 2025 Accepting new patients
Midwest Radiology Outpatient Imaging, LLC Diagnostic Radiology CurrentSince Aug 1, 2019 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
Ridgeview Medical Center Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Radiologists of Univ of Rochester Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Fairview Express Care CurrentSince May 1, 2021 Accepting new patients
Allina Health System CurrentSince Aug 1, 2019 Accepting new patients
St Josephs Hospital and Health Center CurrentSince Jan 13, 2023 Accepting new patients
The Duluth Clinic LTD CurrentSince May 21, 2025 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Madison Healthcare Services CurrentSince Apr 19, 2024 Accepting new patients
Allina Health System CurrentSince Aug 1, 2019 Accepting new patients
Midwest Radiology, PA Diagnostic Radiology CurrentSince Aug 1, 2019 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 15, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2019 Accepting new patients
St. Joseph's Hospital and Health Center Current Accepting new patients
NPI 1083910871 Past Accepting new patients
Ridgeview Medical Center Past Accepting new patients
Range Regional Health Services Past Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Feb 1, 2020 Accepting new patients
Coal Country Community Health Center Past Accepting new patients

Locations (25 of 54)

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

14000 Nicollet Ave
Ste 204
Burnsville, MN 55337
Phone (952) 898-2333

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 130
Chaska, MN 55318
Phone (952) 456-7400

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

820 3rd Ave
Madison, MN 56256
Phone (320) 598-3552

900 2nd Ave
Madison, MN 56256
Phone (320) 598-7536

12000 Elm Creek Blvd N
Ste 310
Maple Grove, MN 55369
Phone (763) 416-7888

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

11850 Blackfoot St NW
Ste 180
Minneapolis, MN 55433
Phone (763) 795-1600

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

4801 W 81st St
Ste 108
Minneapolis, MN 55437
Phone (952) 837-9700

6545 France Ave S
Ste 115
Minneapolis, MN 55435
Phone (952) 893-1997

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

Organizations & group practices 56

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.

View all 56

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1609118710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 FORT HAMILTON PKWY",
            "address_2": "FL 6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANARO",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "65173",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "339293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.