Look up the most recent NPI and PECOS records

Bruce G Manley

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as BRUCE MANLEY.

Based on the most recent information from CMS, provider Bruce G Manley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:35 PM.

Profile Details

Provider ID
1124114525
Provider Type
Individual
Full Name
Manley, Bruce G
Title
Mr.
Credential
PA-C

Gender
Male
Sole Proprietor
Yes
Enumeration Date
10/4/2006
Last Updated
5/11/2012

Contact Information

Practice Location

22 Bramhall St, Portland, ME 04102-3134

(207) 662-7010

(207) 662-8133

Mailing Location

22 Bramhall St, Portland, ME 04102-3134

(207) 662-7010

(207) 662-8133

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA-599 Maine

Bruce G Manley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Nason, Joshua

Lyon, Devin Judith

King, Abby

Mclean, Skye Journey

Harvey, Amy Christine

Large, Daniel

Erickson, Cheri

Taisey, Amy G

Lebourdais, Laura Ann

Pearson, Melinda M