Active NPI
Anthony J Mancuso, OD
- Optometrist
- Blairsville, PA
National Provider Identifier
1700843398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG000818
- Practice address
- 155 E Market St
Suite 2
Blairsville, PA 15717-1357 - Phone
- (724) 459-6610
- Fax
- (724) 459-6630
- NPI assigned
- Apr 27, 2006
- Last updated
- May 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000818 | PA | Primary |
Addresses
Primary practice location
155 E Market St
Suite 2
Blairsville, PA 15717-1357
Mailing address
155 E Market St
Suite 2
Blairsville, PA 15717-1357
Phone (724) 459-6610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00346769 | Other | PA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG000818 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1700843398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 E MARKET ST",
"address_2": "SUITE 2",
"city": "BLAIRSVILLE",
"state": "PA",
"postal_code": "157171357",
"telephone_number": "724-459-6610",
"fax_number": "724-459-6630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 E MARKET ST",
"address_2": "SUITE 2",
"city": "BLAIRSVILLE",
"state": "PA",
"postal_code": "157171357",
"telephone_number": "724-459-6610",
"fax_number": "724-459-6630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCUSO",
"first_name": "ANTHONY",
"middle_name": "J",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG000818",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00346769",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blairsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.