MR. MARK WARREN MCMANUS MD
NPI 1558304097
Family Medicine in Morganton, NC

Active since June 13, 2006PECOS EnrolledAccepts Medicare Assignment
6336 US HIGHWAY 64, MORGANTON, NC 28655(828) 430-9004(828) 430-9444 Get Directions Write a Review

NPPES record last updated: January 31, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Mark Warren Mcmanus Md NPPES

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

MR. MARK WARREN MCMANUS MD (NPI 1558304097) is an individual family medicine provider in Morganton, North Carolina, licensed in North Carolina (33273) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Blue Ridge Healthcare Hospitals, Inc, and maintains a secondary practice location in Morganton.

NPPES Registry Identity

NPI1558304097
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. MARK WARREN MCMANUSCredential: MD
Location Address6336 US HIGHWAY 64Morganton, NC 28655-7141
Mailing Address201 Ervin RdMorganton, NC 28655-2511 · (828) 438-1169
Fax(828) 430-9444
Sole ProprietorYes
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 1987
Enumeration DateJune 13, 2006
Last NPPES UpdateJanuary 31, 2023
NPPES CertifiedJanuary 31, 2023
NPI 1558304097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NC · 33273
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.
6336 US HIGHWAY 64, Morganton, NC 28655

Secondary Practice Location 1

Location 1304 S Green StMorganton, NC 28655-3527 · Phone (828) 430-9004 · Fax (828) 430-9444

Other Identifiers 2

Other57849NC · Blue Cross Blue Shield
Medicaid8957849NC

Accepted Insurance

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. Mark Warren Mcmanus Md 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 ID8729041892
PECOS Enrollment IDI20100827000904
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 14

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.
346 services160 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
229 services59 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
179 services56 patients
Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489
Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.
163 services35 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
81 services59 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
80 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Blue Ridge Healthcare Hospitals, Inc

Acute Care Hospitals · Morganton, NC
3/5 CMS rating
OwnershipProprietary
CMS Certification Number340075
Location2201 S Sterling StMorganton, NC 28655 · Burke County
Emergency services Birthing friendly

The Mcdowell Hospital

Acute Care Hospitals · Marion, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340087
Location430 Rankin Drive P O Box 730Marion, NC 28752 · Mc Dowell County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28655 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Referred Medical Equipment & Supplies CMS DME claims 17

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers29 claims67 services$6.05 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers13 claims19 services$0.87 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers13 claims13 services$82.57 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers13 claims33 services$35.95 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers15 claims81 services$21.78 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
5 suppliers20 claims20 services$63.29 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

Nurse Practitioner
6336 US HIGHWAY 64
MORGANTON, NC 28655
Family Medicine
6336 US HIGHWAY 64
MORGANTON, NC 28655
Physician Assistant
6336 US HIGHWAY 64
MORGANTON, NC 28655
Physician Assistant
6336 US HIGHWAY 64
MORGANTON, NC 28655

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 Mark Mcmanus's NPI number?

The NPI number for Mark Mcmanus is 1558304097. It was assigned to this individual provider in the NPPES registry on June 13, 2006.

Where is Mark Mcmanus located?

Mark Mcmanus practices at 6336 Us Highway 64, Morganton, NC 28655. The listed phone number is (828) 430-9004.

What is Mark Mcmanus's specialty?

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

Is Mark Mcmanus enrolled in Medicare?

Yes. Mark Mcmanus 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.

What insurance does Mark Mcmanus accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and UnitedHealthcare list Mark Mcmanus as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mark Mcmanus affiliated with any hospitals?

According to CMS data, Mark Mcmanus is affiliated with Blue Ridge Healthcare Hospitals, Inc and The Mcdowell Hospital.

When was this NPI record last updated?

The NPPES record for Mark Mcmanus was last updated on January 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.