PHYLLIS JOHNNA MANNA (PA-C) – Medical Physician Assistant, NPI 1528294667
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PHYLLIS JOHNNA MANNA (PA-C)
101, Skaggs Road, Branson, Taney County, Missouri, 65616, United States
SUITE 302
BRANSON, MO 656162075
Phone: (417) 334-8288
Fax: (417) 334-6966
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-04-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090702000344 | I | Physician Assistant | MO | TBD |
| I20180417001439 | I | Physician Assistant | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90960 | Dialysis services, 4 or more physician visits per month (20 years or older) | 19 | 13 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 17 | 14 | $0 |
Insurance plans in this area (ZIP 65616)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E P H R O L O G Y | MO | |
| Nephrology, Internal Medicine | MO | |
| Nephrology, Internal Medicine | AR | |
| Nurse Practitioner | AR | |
| Physician Assistant | MO | |
| - | MO | |
| Certified Clinical Nurse Specialist (Cns) | MO |
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