Kimberly J. Manganaro, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD033635E Issued in PA

Practice address

106 Derry Heights Blvd
Lewistown, PA 17044-8604

Phone

(717) 363-9077

Fax

(570) 558-6161

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kmanganaro13381@direct.geisinger.edu

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1730140310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 DERRY HEIGHTS BLVD",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170448604",
            "telephone_number": "717-363-9077",
            "fax_number": "570-558-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANARO",
        "first_name": "KIMBERLY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD033635E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001009889",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmanganaro13381@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "106 Derry Heights Blvd",
            "city": "Lewistown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170448604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelley Machado, PA-C
• Sai Mounica Maddu, MD
• Roshan Mainali, M.D.
• Shashpal K Malhotra, MD
• Crystal Manbeck, RN, BSN
• Ivana L Marji, MD
• Dawn Michelle Markel, LPN
• Scott David Marlowe, MD
• Kaitlin Marshall
• Deborah L Martin, LMT

• Family Medicine Physician in Lewistown, PA
• Providers in Lewistown, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.