Thomas Mangiaracina, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

124929 Issued in NY

Practice address

170 Taylor Road
Box 115
Mountainville, NY 10953-0115

Phone

(845) 551-0140

Fax

(845) 534-4229

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

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.

• Hudson Valley Pulmonary & Med Assoc PC

  • Pulmonary Disease Physician
  • New Windsor, NY
  • NPI 1649384678

  Pulmonary Disease

  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 27, 2015.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1992898985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "MOUNTAINVILLE",
            "state": "NY",
            "postal_code": "109530115",
            "telephone_number": "845-551-0140",
            "fax_number": "845-534-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 TAYLOR ROAD",
            "address_2": "BOX 115",
            "city": "MOUNTAINVILLE",
            "state": "NY",
            "postal_code": "109530115",
            "telephone_number": "845-551-0140",
            "fax_number": "845-534-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIARACINA",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "124929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE9235",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00513662",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER ID",
            "identifier": "290009841",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renate Frieda Herzich, RD, CDE, CDN

• All providers in Mountainville, NY
• Pulmonary Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.