Mary Moon Manzo, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 449 Issued in RI

Practice address

19 Friendship St
Newport, RI 02840-2272

Phone

(401) 849-6868

Fax

(401) 847-3840

NPI assigned

Aug 17, 2006

Last updated

Feb 16, 2012By the provider in NPPES

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elliot Hospital Hospital, Manchester, NH, CCN 300012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935
  Medicare reassignment Care Compare group
• Memorial Hospital

  • General Acute Care Hospital
  • Pawtucket, RI
  • NPI 1548696941
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028
  Care Compare affiliation

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1730292244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-849-6868",
            "fax_number": "401-847-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402272",
            "telephone_number": "401-849-6868",
            "fax_number": "401-847-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZO",
        "first_name": "MARY",
        "middle_name": "MOON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "RI",
            "license": "PA 449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "414659",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "33279",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI LICENSE",
            "identifier": "PA 449",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Mahan
• Melissa Maheu, MS, RD, LDN
• Shabana Majeed, MD
• Micah Manuel
• Elizabeth R Manzo, MD
• Madyson Adele Marcelin
• Mark Appleman, MD
• Laureen J. Martin, RNP
• Lauren Martin
• William Henry Martland, MD

• Surgical Physician Assistant in Newport, RI
• Providers in Newport, RI by specialty
• Surgical Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.