Anthony Mannino, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO02797 Issued in AZ

Practice address

126 E Main St
Ste B
Payson, AZ 85541

Phone

(928) 468-8610

Fax

(928) 468-8605

NPI assigned

Apr 8, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Alliance Urgent Care PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tolleson, AZ
  • NPI 1891888517

  AZ

  Medicare reassignment NPD
• Dignity Community Care

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189

  AZ

  Medicare reassignment NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1619345675

  Family Medicine

  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Williams, AZ
  • NPI 1750691788
  NPD
• Arizona Heart Specialists PLLC

  • Cardiovascular Disease Physician
  • Lakeside, AZ
  • NPI 1750513438
  NPD (past)
• Chandler Regional Medical Center

  • Emergency Care Clinic/Center
  • Chandler, AZ
  • NPI 1871910968
  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1700849072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630",
            "telephone_number": "928-522-9879",
            "fax_number": "928-522-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "85541",
            "telephone_number": "928-468-8610",
            "fax_number": "928-468-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "DO02797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133760",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0856210",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Hector Lopez, MD
• Loran C Jacobs Jr PLLC
• Durward Lynch, CNP
• David Wood Lyons, NP
• M & K Health Services
• Mark a Meyers
• Mark Ivey Jr MD PC
• Michael Allan Marmer, M.D.
• Lori Anne Martinez, MA, LPC, LISAC
• Craig Mathews

• All providers in Payson, AZ
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.