Alfredo Manalo, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS025542L Issued in PA

Practice address

5615 Route 8
Gibsonia, PA 15044-9553

Phone

(724) 444-4777

Fax

(724) 444-5770

NPI assigned

Nov 22, 2005

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Primary Health Network

  • Federally Qualified Health Center (FQHC)
  • Sharon, PA
  • NPI 1417932609
  Medicare reassignment NPD
• Primary Health Network

  • Federally Qualified Health Center (FQHC)
  • Emlenton, PA
  • NPI 1750181038
  NPD

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1750364949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 MERIDIAN DR",
            "city": "PRESTO",
            "state": "PA",
            "postal_code": "151421033",
            "telephone_number": "724-444-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 ROUTE 8",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449553",
            "telephone_number": "724-444-4777",
            "fax_number": "724-444-5770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2807 Wilmington Rd",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "PA",
            "postal_code": "161051263",
            "country_code": "US",
            "telephone_number": "724-656-3486",
            "fax_number": "724-598-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Sharon New Castle Rd",
            "address_purpose": "LOCATION",
            "city": "Farrell",
            "state": "PA",
            "postal_code": "161211576",
            "country_code": "US",
            "telephone_number": "724-981-1721",
            "fax_number": "724-981-7025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANALO",
        "first_name": "ALFREDO",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS025542L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2264428",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010767560029",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPA ID",
            "identifier": "0010767560013",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010767560038",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendal Mader, LAT, ATC, PES
• Nina Madia
• Michael Magness, COTA
• Mark L Mallinger, MD
• Lucas Malmberg
• Jessica Mantella, PA-C
• William Harold Masters II, RDN, LDN
• Caitlin Maxwell
• Noralynn Luffy Mayer, RN
• Linnea Rochelle McAfoose

• Oral and Maxillofacial Surgery (Dentist) in Gibsonia, PA
• Providers in Gibsonia, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.