Individual provider Active NPI

Antonino Mannone, M.D.

  • Gastroenterology Physician
  • Williamsville, NY
National Provider Identifier
1821073388
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
159226 Issued in NY
Practice address
8201 Main St
Suite 4
Williamsville, NY 14221-6046
Phone
(716) 632-3577
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 159226 NY Primary

Addresses

Primary practice location

8201 Main St
Suite 4
Williamsville, NY 14221-6046

Mailing address

8201 Main Street
Suite 4
Williamsville, NY 14221-5934
Phone (716) 632-3577

Other identifiers 1

IdentifierTypeStateIssuer
00902098MedicaidNY

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080116000386 NY Practitioner - Gastroenterology 0345227880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8201 Main St
Williamsville, NY 14221-6046
Phone 7166323577204

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy83
Upper gastrointestinal (GI) endoscopy for acid reflux35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
159226NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsville Gastroenterology Associates P.C. CurrentSince Jul 2, 2004 Accepting new patients
Main Gastroenterology. P.C. Gastroenterology CurrentSince Dec 17, 2007 Accepting new patients

Locations

6637 Main St
Williamsville, NY 14221
Phone (716) 632-1595

8201 Main St
Ste 4
Williamsville, NY 14221
Phone (716) 626-6626

Interoperability endpoints

  • Direct secure messaging: dramannone@maingastro.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1821073388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 MAIN STREET",
            "address_2": "SUITE 4",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215934",
            "telephone_number": "716-632-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 MAIN ST",
            "address_2": "SUITE 4",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216046",
            "telephone_number": "716-632-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNONE",
        "first_name": "ANTONINO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "159226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00902098",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.