NPIMap

Individual provider Active NPI

John W Mannschreck, M.D.

  • Diagnostic Radiology Physician
  • Clarkston, WA
National Provider Identifier
1942251376
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00026768 Issued in WA
Practice address
1254 Highland Ave
Clarkston, WA 99403-2841
Phone
(509) 758-6132
Fax
(509) 751-9726
NPI assigned
May 12, 2006
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M-6236 ID
Diagnostic Radiology Physician 2085R0202X MD00026768 WA Primary

Addresses

Primary practice location

1254 Highland Ave
Clarkston, WA 99403-2841

Mailing address

1254 Highland Ave
Clarkston, WA 99403-2841
Phone (509) 758-6132

Other practice location 1

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200

Other identifiers 4

IdentifierTypeStateIssuer
72728OtherWABLUE CROSS OF IDAHO
1121334MedicaidWA
P00186232OtherWARAILROAD MEDICARE
000010149194OtherWAREGENCE BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID, AK3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050111000257 WA Practitioner - Diagnostic Radiology 2466438205 Reassigns benefits to 7 organizations
I20050215000439 ID Practitioner - Diagnostic Radiology 2466438205 Reassigns benefits to 6 organizations
I20241108002476 AK Practitioner - Diagnostic Radiology 2466438205 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skagit Radiology Inc P SGroup PAC ID 7113815218, 39 clinicians
North Star Medical Imaging PLLCGroup PAC ID 7214005099, 30 clinicians

Practice addresses (Care Compare)

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 424-6161

2716 Country Club Dr
Lewiston, ID 83501-9603
Phone (360) 424-6161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-6236IDMDDiagnostic Radiology Physician
MD00026768WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey Island Public Hospital District Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Vannvei LLC CurrentSince Mar 9, 2021 Accepting new patients
North Star Medical Imaging PLLC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Aug 1, 2024 Accepting new patients
Whidbey Island Public Hospital District CurrentSince Sep 1, 2024 Accepting new patients
Fairbanks Medical Imaging LLC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Tri-State Memorial Hospital CurrentSince Nov 18, 2019 Accepting new patients
Whidbey Island Public Hospital District CurrentSince Sep 19, 2024 Accepting new patients
Bellingham Advanced Medical Imaging LLC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Vannvei LLC CurrentSince Mar 9, 2021 Accepting new patients
Skagit Radiology Inc P S Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients

Locations

2310 Peger Rd
Ste 102
Fairbanks, AK 99709

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

1522 17th St
Lewiston, ID 83501
Phone (208) 743-8416

2841 Juniper Dr
#2
Lewiston, ID 83501
Phone (208) 848-9001

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

1344 King St
Ste 101
Bellingham, WA 98229
Phone (360) 676-6393

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

125 N 18th St
Ste C
Mount Vernon, WA 98273
Phone (360) 428-7274

1320 E Division St
Mount Vernon, WA 98274
Phone (360) 424-9607

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1942251376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 HIGHLAND AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032841",
            "telephone_number": "509-758-6132",
            "fax_number": "509-751-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 HIGHLAND AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032841",
            "telephone_number": "509-758-6132",
            "fax_number": "509-751-9726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "983682443",
            "country_code": "US",
            "telephone_number": "360-385-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNSCHRECK",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-6236",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00026768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "72728",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1121334",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00186232",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010149194",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

Verify at the official NPI Registry.