Active NPI
Maria Alba McManus, R.P.A.C.
- Physician Assistant
- Port Jefferson Station, NY
National Provider Identifier
1821051921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002224
- Practice address
- 815 Hallock Ave
Port Jefferson Station, NY 11776-1244 - Phone
- (631) 929-0325
- Fax
- (631) 929-0360
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002224 | NY | Primary |
Addresses
Primary practice location
815 Hallock Ave
Port Jefferson Station, NY 11776-1244
Mailing address
PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 209-5090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002224 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1821051921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1559",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117900989",
"telephone_number": "631-209-5090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 HALLOCK AVE",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761244",
"telephone_number": "631-929-0325",
"fax_number": "631-929-0360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMANUS",
"first_name": "MARIA",
"middle_name": "ALBA",
"name_prefix": "Ms.",
"credential": "R.P.A.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "002224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.