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DIANA M MANCUSO MD PA
NPI 1366692246
Family Medicine in Dothan, AL

Active since September 26, 2008CLIA 01D0304710 · Microscopy
4300 W MAIN ST, SUITE 16, DOTHAN, AL 36305(334) 793-4120(334) 615-8443 Get Directions Write a Review

NPPES record last updated: March 9, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Diana M Mancuso Md Pa NPPES

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

DIANA M MANCUSO MD PA (NPI 1366692246) is a healthcare organization registered as a family medicine in Dothan, Alabama and active in the NPI registry since September 2008. The organization holds a CLIA Microscopy certificate valid through August 18, 2028 and lists Diana M Mancuso, President, as its authorized official.

NPPES Registry Identity

NPI1366692246
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDIANA M MANCUSO MD PA
Location Address4300 W MAIN ST, SUITE 16Dothan, AL 36305-1054
Mailing Address4300 W Main St, Suite 16Dothan, AL 36305-1054 · (334) 793-4120 · Fax (334) 615-8443
Phone(334) 793-4120
Fax(334) 615-8443
Organization SubpartNo
Authorized OfficialDiana M MancusoPresident · (334) 793-4120
Enumeration DateSeptember 26, 2008
Last NPPES UpdateMarch 9, 2009
✔ NPI 1366692246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AL · 4436
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4300 W MAIN ST, Dothan, AL 36305
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Other Identifiers 4

Medicare UPINC72543AL
Medicaid000000013AL
Other000000013AL · Medicare Provider Number
Medicare PIN000000013AL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diana M Mancuso Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Diana M Mancuso MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Diana Mancuso, M.D.
Family Practice
NPI 1417971037
4300 W MAIN ST SUITE 16
Dothan, AL 36305
(334) 793-4120
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 01D0304710

Diana M Mancuso MD · Dothan, AL
Active · expires Aug 18, 2028
CLIA Number01D0304710
Laboratory TypePhysician Office
Certificate Effective DateAugust 19, 2026
Certificate Expiration DateAugust 18, 2028
Laboratory DirectorDiana M. Mancuso
Laboratory Phone(334) 793-4120
Laboratory LocationDiana M Mancuso MD4300 W Main Suite #16, Dothan, AL 36305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diana M Mancuso MD PA's NPI number?

The NPI number for Diana M Mancuso MD PA is 1366692246. It was assigned to this organization in the NPPES registry on September 26, 2008.

Where is Diana M Mancuso MD PA located?

Diana M Mancuso MD PA is located at 4300 W Main St Suite 16, Dothan, AL 36305. The listed phone number is (334) 793-4120.

What is Diana M Mancuso MD PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Diana M Mancuso MD PA enrolled in Medicare?

Yes. Diana M Mancuso MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Diana M Mancuso MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Diana M Mancuso MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Diana M Mancuso MD PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 01D0304710) is associated with this NPI, valid through August 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Diana M Mancuso MD PA was last updated on March 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.