Individual provider Active NPI

Thomas Frank Mammana, D.C.

  • Chiropractor
  • Summerfield, FL
National Provider Identifier
1740206572
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2831 Issued in FL
Practice address
26262 Hwy 441 Suite 200
Summerfield, FL 34491
Phone
(352) 307-0033
Fax
(352) 307-1998
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2831 FL Primary

Addresses

Primary practice location

26262 Hwy 441 Suite 200
Summerfield, FL 34491

Mailing address

26262 Hwy 441 Suite 200
Summerfield, FL 34491
Phone (352) 307-0033

Other identifiers 1

IdentifierTypeStateIssuer
3813525-00MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080603000752 FL Practitioner - Chiropractic 6709956642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15151 S US Hwy 441
Suite 200
Summerfield, FL 34491-4482
Phone (352) 307-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic Rehabilitation and Wellness Center Chiropractor CurrentSince Nov 7, 2007 Accepting new patients

Locations

15151 S US Highway 441
Summerfield, FL 34491
Phone (352) 304-3148

15151 S US Highway 441
Ste 200
Summerfield, FL 34491
Phone (352) 307-0033

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1740206572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26262 HWY 441 SUITE 200",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "34491",
            "telephone_number": "352-307-0033",
            "fax_number": "352-307-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26262 HWY 441 SUITE 200",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "34491",
            "telephone_number": "352-307-0033",
            "fax_number": "352-307-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMANA",
        "first_name": "THOMAS",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3813525-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.