NPIMap

Individual provider Active NPI

Dustin Joseph Manchester, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fountain Hill, PA
National Provider Identifier
1720306210
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD453662 Issued in PA
Practice address
701 Ostrum St Ste 503
Fountain Hill, PA 18015
Phone
(484) 526-3950
Fax
(866) 954-9593
NPI assigned
May 10, 2010
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT197082 PA
Surgery Physician 208600000X MT197082 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD453662 PA Primary

Addresses

Primary practice location

701 Ostrum St Ste 503
Fountain Hill, PA 18015

Mailing address

701 Ostrum St Ste 503
Fountain Hill, PA 18015-1153
Phone (484) 526-3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180703001590 PA Practitioner - Thoracic Surgery 7113206269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

701 Ostrum St
Suite 503
Fountain Hill, PA 18015-1153
Phone (484) 526-3950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT197082PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jul 16, 2018 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Jul 16, 2018 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients
St Lukes Hospital Past Accepting new patients

Locations

701 Ostrum St
Ste 201
Fountain Hill, PA 18015
Phone (610) 868-1014

701 Ostrum St
Ste 503
Fountain Hill, PA 18015
Phone (484) 526-3950

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: dustin.manchester@slpg.direct-sluhn.org

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1720306210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 503",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151153",
            "telephone_number": "484-526-3950",
            "fax_number": "866-954-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 503",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "18015",
            "telephone_number": "484-526-3950",
            "fax_number": "866-954-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "DUSTIN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT197082",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT197082",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD453662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.