Ray Peter Mangulabnan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301072416 Issued in MI

Practice address

3170 Hallmark CT
Saginaw, MI 48603-2183

Phone

(989) 790-1275

Fax

(989) 249-4199

NPI assigned

Oct 7, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1003804766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 MANCHESTER DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486099220",
            "telephone_number": "989-781-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 HALLMARK CT",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032183",
            "telephone_number": "989-790-1275",
            "fax_number": "989-249-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGULABNAN",
        "first_name": "RAY",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301072416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7307374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N48190001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "1107304342",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS OF MI",
            "identifier": "0992071",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL SERVICES ADMIN",
            "identifier": "4411167",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4411167",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7307374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P25942F",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMM CHOICE CARE SOURCE",
            "identifier": "010683841050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN PHYS SERVICES",
            "identifier": "0N48190",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QMXPR0027616",
            "identifier": "MOLINA",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chandramouli Srinivasa Mandalaparty, DO
• Victoria M Mandigo, LPTA, LMT
• Sohaib Mandoorah
• Nicole Mangin
• Aliah Kei Manglona, DO
• Nicholas James Mangutz
• Manifest Life Counseling
• Anuraag Manjunatha, MD
• Albert SM Manlapit, MD
• Iris Marteja Manlapit, MD

• Internal Medicine Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.