Active NPI
Daniel G Manion, PA
- Physician Assistant
- Santa Cruz, CA
National Provider Identifier
1821145749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA52173
- Practice address
- 1575 Soquel Dr
Ste C
Santa Cruz, CA 95065-1700 - Phone
- (650) 934-3546
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA52173 | CA | Primary |
| Surgical Physician Assistant | 363AS0400X | 100380 | NC | |
| Physician Assistant | 363A00000X | PA1570 | KY |
Addresses
Primary practice location
1575 Soquel Dr
Ste C
Santa Cruz, CA 95065-1700
Mailing address
P.O. Box 2917
Pikeville, KY 41502-2917
Phone (606) 218-3500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7901940 | Medicaid | NC | |
| 970003664 | Other | NC | RAILROAD MEDICARE |
| 7100123670 | Medicaid | KY |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52173 | CA | MD | Geriatric Pharmacist |
| PA52173 | CA | MD | Physician Assistant |
| PA1570 | KY | MD | Physician Assistant |
| 100380 | NC | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1821145749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 2917",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415022917",
"telephone_number": "606-218-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 SOQUEL DR",
"address_2": "STE C",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651700",
"telephone_number": "650-934-3546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANION",
"first_name": "DANIEL",
"middle_name": "G",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA52173",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NC",
"license": "100380",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA1570",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7901940",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "970003664",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100123670",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.