NPIMap

Organization Active NPI

Mason Hospital District

Doing business as Manito Medical Associates

  • Family Medicine Physician
  • Manito, IL
National Provider Identifier
1902340748
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MASON HOSPITAL DISTRICT
Doing business as
Manito Medical Associates
Practice address
1301 S East Ave
Manito, IL 61546
Phone
(309) 968-5311
NPI assigned
Dec 13, 2016
Last updated
Dec 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Authorized official

Name
Mary L Layton
Title
Director of Clinic Operations
Phone
(309) 543-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1301 S East Ave
Manito, IL 61546

Mailing address

PO Box 530
Havana, IL 62644-0530
Phone (309) 543-6600

Other names 1

  • Manito Medical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000399 IL Part B Supplier - Clinic/Group Practice 2466360607 Receives reassigned benefits from 55 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Havana, IL; Manito, IL; Mason City, IL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Asadullah Saira MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1902340748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626440530",
            "telephone_number": "309-543-6600",
            "fax_number": "309-543-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S EAST AVE",
            "city": "MANITO",
            "state": "IL",
            "postal_code": "61546",
            "telephone_number": "309-968-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "LAYTON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC OPERATIONS",
        "authorized_official_telephone_number": "309-543-6600"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manito Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manito, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.