Grace Anne Mangione

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9122319 Issued in FL

Practice address

27499 Riverview Center Blvd Ste 213
Bonita Springs, FL 34134-4334

Phone

(239) 345-8001

NPI assigned

Jul 24, 2026

Last updated

Sep 23, 2026By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prime Medical Health and Wellness LLC

  • Internal Medicine Physician
  • Bonita Springs, FL
  • NPI 1790331759
  NPD
• Jimmy Liu, M.D., P.a.

  • Internal Medicine Physician
  • Bonita Springs, FL
  • NPI 1194184861
  NPD (past)

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1619898640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27499 RIVERVIEW CENTER BLVD STE 213",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27499 RIVERVIEW CENTER BLVD STE 213",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344334",
            "telephone_number": "239-345-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIONE",
        "first_name": "GRACE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9122319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larisa Igorevna Macedo, DMD
• Frank Patrick Macias, PHARMD
• Madison American Bonita Springs TRS I, LLC (American House Bonita)
• Anthony Steven Maltais
• Robert Vincent Mandraccia, MD
• Denise L Manzo, HIS
• Maple Tree Home Health, Inc.
• Marciano Dental Group
• Nicholas Joseph Marciano, DMD
• Margaret a Thomson LCSW (Peggy A Thomson LCSW)

• Physician Assistant in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.