NPIMap

Organization Active NPI

Ear, Nose, and Throat Associates of Manatee, PA

  • Specialist
  • Bradenton, FL
National Provider Identifier
1730230764
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME85106 Issued in FL
Legal business name
EAR, NOSE, AND THROAT ASSOCIATES OF MANATEE, PA
Practice address
701 Manatee Ave W
Suite 202
Bradenton, FL 34205-8604
Phone
(941) 748-2455
Fax
(941) 750-9704
NPI assigned
Jan 16, 2007
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Mrs. Joan Overby, CMPE
Title
Administrator
Phone
(941) 748-2455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME85106 FL Primary

Addresses

Primary practice location

701 Manatee Ave W
Suite 202
Bradenton, FL 34205-8604

Mailing address

701 Manatee Ave W
Suite 202
Bradenton, FL 34205-8604
Phone (941) 748-2455

Other practice location 1

1838 Rye Rd
Bradenton, FL 34212-9038
Phone (941) 748-2455

Other practice location 2

8340 Lakewood Ranch Blvd Ste 180
Lakewood Ranch, FL 34202-5185
Phone (941) 748-2455

Other practice location 3

772 Cortaro Dr
Ruskin, FL 33573-6811
Phone (941) 748-2455

Other identifiers 1

IdentifierTypeStateIssuer
99617OtherFLGROUP NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address joano@entofmanatee.emadirect.md Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820000370 FL Part B Supplier - Clinic/Group Practice 6406820026 Receives reassigned benefits from 12 practitioners
Practice locations: Bradenton, FL; Lakewood Ranch, FL; Ruskin, FL

National Provider Directory

National Provider Directory

Locations

1838 Rye Rd
Bradenton, FL 34212
Phone (941) 462-2004

Interoperability endpoints

  • Direct secure messaging: joano@entofmanatee.emadirect.md

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1730230764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MANATEE AVE W",
            "address_2": "SUITE 202",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058604",
            "telephone_number": "941-748-2455",
            "fax_number": "941-750-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MANATEE AVE W",
            "address_2": "SUITE 202",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058604",
            "telephone_number": "941-748-2455",
            "fax_number": "941-750-9704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1838 Rye Rd",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342129038",
            "country_code": "US",
            "telephone_number": "941-748-2455",
            "fax_number": "941-746-4554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8340 Lakewood Ranch Blvd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342025185",
            "country_code": "US",
            "telephone_number": "941-748-2455",
            "fax_number": "941-746-4554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "772 Cortaro Dr",
            "address_purpose": "LOCATION",
            "city": "Ruskin",
            "state": "FL",
            "postal_code": "335736811",
            "country_code": "US",
            "telephone_number": "941-748-2455",
            "fax_number": "941-746-4554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAR, NOSE, AND THROAT ASSOCIATES OF MANATEE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "OVERBY",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-748-2455",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME85106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "99617",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joano@entofmanatee.emadirect.md",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "701 Manatee Ave W",
            "address_2": "Suite 202",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342058604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.