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FAIRY LAINE ESPINA MANZANO
NPI 1417572173
Nurse Practitioner - Psychiatric/Mental Health in Lynbrook, NY

Active since June 09, 2020PECOS EnrolledAccepts Medicare Assignment
20 EXETER AVE, LYNBROOK, NY 11563(347) 351-2454 Get Directions Write a Review

NPPES record last updated: April 13, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 13, 2025, Jun 9, 2020 (2 updates tracked since 2020).

About Fairy Laine Espina Manzano NPPES

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

FAIRY LAINE ESPINA MANZANO (NPI 1417572173) is an individual psychiatric/mental health provider in Lynbrook, New York, licensed in New York (406726) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1417572173
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameFAIRY LAINE ESPINA MANZANO
Location Address20 EXETER AVELynbrook, NY 11563-3710
Mailing Address600 E 125th StNew York, NY 10035-6000 · (646) 766-4000
Phone(347) 351-2454
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJune 9, 2020
Last NPPES UpdateApril 13, 20252 updates tracked since enumeration
NPPES CertifiedApril 13, 2025
✔ NPI 1417572173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · 406726
Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License 730040 (NY)
20 EXETER AVE, Lynbrook, NY 11563
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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

Fairy Laine Espina Manzano 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 ID9234639089
PECOS Enrollment IDI20250826000370
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11563 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Fairy Laine Manzano's NPI number?

The NPI number for Fairy Laine Manzano is 1417572173. It was assigned to this individual provider in the NPPES registry on June 9, 2020.

Where is Fairy Laine Manzano located?

Fairy Laine Manzano practices at 20 Exeter Ave, Lynbrook, NY 11563. The listed phone number is (347) 351-2454.

What is Fairy Laine Manzano's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Fairy Laine Manzano enrolled in Medicare?

Yes. Fairy Laine Manzano is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Fairy Laine Manzano was last updated on April 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.