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

Mary Moon Manzo, PA-C

Individual provider Surgical Physician Assistant · NPI 1730292244

Mary Moon Manzo, PA-C is a Physician Assistant in Newport, Rhode Island. Qualified in 2001, 25 years ago. Practices with Elliot Professional Services, a 424-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
25
Licensed in
RI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

19 Friendship St
Newport, RI 02840-2272
Phone: (401) 849-6868
Fax: (401) 847-3840
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA 449 (RI)

Record details

NPI number1730292244
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 17, 2006
Last updated in NPPESFebruary 16, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Elliot Professional Services — 424 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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