Individual provider Active NPI

Joseph A Mannino, MD

  • Orthopaedic Surgery Physician
  • Ithaca, NY
National Provider Identifier
1720047996
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
217114 Issued in NY
Practice address
16 Brentwood Dr
Ithaca, NY 14850-1863
Phone
(607) 272-7000
Fax
(607) 272-4694
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 217114 NY Primary

Addresses

Primary practice location

16 Brentwood Dr
Ithaca, NY 14850-1863

Mailing address

16 Brentwood Dr
Ithaca, NY 14850-1863
Phone (607) 272-7000

Other identifiers 1

IdentifierTypeStateIssuer
02137319MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20090615000110 NY Practitioner - Orthopedic Surgery 7810977659 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217114NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler Hospital Inc CurrentSince Dec 1, 2021 Accepting new patients
Schuyler Hospital Inc CurrentSince Dec 1, 2021 Accepting new patients
Joseph a. Mannino M.D., P.C. Orthopaedic Surgery PastSince Aug 1, 2002 Accepting new patients

Locations

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1720047996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BRENTWOOD DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501863",
            "telephone_number": "607-272-7000",
            "fax_number": "607-272-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BRENTWOOD DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501863",
            "telephone_number": "607-272-7000",
            "fax_number": "607-272-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "JOSEPH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "217114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02137319",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.