Individual provider Active NPI

Ed Fortune Aguilos Mangio, AGNP-BC

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1659700599
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2304159 Issued in MA
Practice address
119 Belmont St
Worcester, MA 01605-2903
Phone
(508) 334-8515
Fax
(508) 334-6490
NPI assigned
Nov 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2304159 MA Primary

Addresses

Primary practice location

119 Belmont St
Worcester, MA 01605-2903

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

100 South St
Southbridge, MA 01550-4051
Phone (508) 909-7733

Other practice location 2

235 North Pearl St
Brockton, MA 02301
Phone (508) 427-3000

Other practice location 3

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-8515

Other identifiers 1

IdentifierTypeStateIssuer
110108801AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160203001759 MA Practitioner - Nurse Practitioner 6002137783 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians
Marlborough Hospitalist Group PLLCGroup PAC ID 1254793888, 27 clinicians
BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Practice addresses (Care Compare)

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000

157 Union St
Marlborough, MA 01752-1228
Phone (508) 481-5000

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Marlborough Hospital Hospital, Marlborough, MA, CCN 220049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2304159MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Aug 31, 2019 Accepting new patients
Sound Physicians of Massachusetts II PC CurrentSince Jun 17, 2017 Accepting new patients
Umass Memorial Medical Group Inc Nurse Practitioner CurrentSince Oct 7, 2024 Accepting new patients
BMC Affiliated Physicians, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Sound Physicians of Massachusetts, Inc Nurse Practitioner CurrentSince Sep 1, 2016 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 31, 2019 Accepting new patients
Sound Physicians of Massachusetts Inc CurrentSince Sep 1, 2016 Accepting new patients
Marlborough Hospitalist Group, PLLC CurrentSince Mar 1, 2024 Accepting new patients
Lahey Clinic, Inc CurrentSince Nov 5, 2018 Accepting new patients
Lahey Clinic, Inc. CurrentSince Nov 1, 2018 Accepting new patients

Locations

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: emangio259768@direct.bmc.masshiway.net

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1659700599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052903",
            "telephone_number": "508-334-8515",
            "fax_number": "508-334-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 South St",
            "address_purpose": "LOCATION",
            "city": "Southbridge",
            "state": "MA",
            "postal_code": "015504051",
            "country_code": "US",
            "telephone_number": "508-909-7733",
            "fax_number": "508-909-7735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 North Pearl St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "02301",
            "country_code": "US",
            "telephone_number": "508-427-3000",
            "fax_number": "508-427-2209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-8515",
            "fax_number": "508-334-6490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGIO",
        "first_name": "ED FORTUNE",
        "middle_name": "AGUILOS",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-01",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2304159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110108801A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.