MR. OSWALDO GIOVANNI TAGLE MANRIQUE PA-C
NPI 1063057040
Physician Assistant - Medical in Allentown, PA

Q: What is Oswaldo Tagle Manrique's NPI number?

The NPI number for Oswaldo Tagle Manrique is 1063057040. It was assigned to this individual provider in the NPPES registry on November 13, 2019.

Q: What is Oswaldo Tagle Manrique's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since November 13, 2019PECOS EnrolledAccepts Medicare Assignment

1575 POND RD STE 203, ALLENTOWN, PA 18104(610) 366-1366 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 4, 2025, Jun 22, 2023, Feb 11, 2021 and 1 more (4 updates tracked since 2019).

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About Mr. Oswaldo Giovanni Tagle Manrique Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. OSWALDO GIOVANNI TAGLE MANRIQUE PA-C (NPI 1063057040) is an individual medical provider in Allentown, Pennsylvania, licensed in Pennsylvania (MA061118) and active in the NPI registry since November 2019. He is enrolled in Medicare PECOS, is affiliated with Lehigh Valley Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1063057040

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. OSWALDO GIOVANNI TAGLE MANRIQUECredential: PA-C

Location Address1575 POND RD STE 203Allentown, PA 18104-2254

Mailing Address4019 Indian Creek RdEmmaus, PA 18049-1909 · (610) 704-7694

Phone(610) 366-1366

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 2013

Enumeration DateNovember 13, 2019

Last NPPES UpdateFebruary 4, 20254 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2025

✔ NPI 1063057040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in PA · MA061118

1575 POND RD STE 203, Allentown, PA 18104

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Secondary Practice Locations 2

Location 11200 Mokychic RoadCollegeville, PA 19426 · Phone (610) 409-7890

Location 22200 Hamilton St Ste 111Allentown, PA 18104-6329 · Phone (610) 821-8321

Other Identifiers 2

OtherMA061118PA · Medical Physician Assistant License

OtherOA005038PA · Osteopathic Physician Assistant License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Oswaldo Giovanni Tagle Manrique Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981022308

PECOS Enrollment IDI20200917001014

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

49 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390133

Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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