Individual provider Active NPI

Jose M Manjon, MD

  • Obstetrics & Gynecology Physician
  • Harrisburg, PA
National Provider Identifier
1962497628
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD035254E Issued in PA
Practice address
4300 Londonderry Rd Ste 305
Harrisburg, PA 17109-5317
Phone
(717) 724-6788
Fax
(717) 730-0099
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD035254E PA Primary

Addresses

Primary practice location

4300 Londonderry Rd Ste 305
Harrisburg, PA 17109-5317

Mailing address

4300 Londonderry Rd Ste 305
Harrisburg, PA 17109-5317
Phone (717) 791-2960

Other practice location 1

1600 6th Ave Ste 117
York, PA 17403-2627
Phone (717) 840-9885

Other practice location 2

2025 Technology Pkwy Ste 109
Mechanicsburg, PA 17050-9401
Phone (717) 791-2590

Other identifiers 1

IdentifierTypeStateIssuer
001057812MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmanjon5914@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070613000621 PA Practitioner - Obstetrics/Gynecology 0446358527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

121 Towne Square Dr
Hershey, PA 17033-9440

2025 Technology Pkwy
Mechanicsburg, PA 17050-9401

2501 N 3Rd St
Kline Health Center Foot and Ankle
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd St 2ND FL Kline HC
Reach Program
Harrisburg, PA 17110-1904
Phone (717) 782-2363

2501 N 3Rd St FL
2 Kline Health Center
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd Street 2ND Floor
Pinnaclehealth Psychological Associates
Harrisburg, PA 17110-1904
Phone (717) 782-2143

4300 Londonderry Rd
Harrisburg, PA 17109-5317

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD035254EPAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Jul 29, 1986 Accepting new patients
Pinnacle Health Medical Services Obstetrics & Gynecology Current Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2035 Technology Pkwy
Ste 201
Mechanicsburg, PA 17050
Phone (717) 231-4567

Interoperability endpoints

  • Direct secure messaging: jmanjon295304@upmc.direct-ci.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 7

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1962497628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD STE 305",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-791-2960",
            "fax_number": "717-791-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD STE 305",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-724-6788",
            "fax_number": "717-730-0099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 6th Ave Ste 117",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174032627",
            "country_code": "US",
            "telephone_number": "717-840-9885",
            "fax_number": "717-840-9313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2025 Technology Pkwy Ste 109",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170509401",
            "country_code": "US",
            "telephone_number": "717-791-2590",
            "fax_number": "717-221-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANJON",
        "first_name": "JOSE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD035254E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001057812",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmanjon5914@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2035 Technology Pkwy Ste 201",
            "city": "Mechanicsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170509422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.