Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Jesuitas Manansala

Individual provider Nurse Practitioner · NPI 1437643566

Mark Jesuitas Manansala is a Nurse Practitioner in Syracuse, New York. Qualified in 2018, 8 years ago. Practices with Crouse Health Hospital Inc, a 153-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

301 Prospect Ave
Syracuse, NY 13203
Phone: (315) 448-5111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 343488 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 575973 (NY)

Record details

NPI number1437643566
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 21, 2018
Last updated in NPPESAugust 21, 2018
Mailing address7770 Tirrell Hill Cir, Liverpool, NY 13090-2508

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Crouse Health Hospital Inc — 153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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