Active NPI
Saravanakumar Manickam, MD
- Anesthesiology Physician
- Normal, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036172305
- Practice address
- 1304 Franklin Ave
Normal, IL 61761-3558 - Phone
- (309) 268-5867
- NPI assigned
- Aug 19, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036172305 | IL | Primary |
| Anesthesiology Physician | 207L00000X | 296525 | NY |
Addresses
Primary practice location
1304 Franklin Ave
Normal, IL 61761-3558
Mailing address
611 W Park St
Urbana, IL 61801-2501
Other practice location 1
1 Guthrie Dr
Corning, NY 14830-3696
Phone (607) 937-7200
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | msaravankumar146207@direct-guthrie.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Bromenn Medical Center
- St Joseph Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036172305 | IL | MD | Anesthesiology Physician |
| 296525 | NY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Anesthesiology | Current | Accepting new patients |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Anesthesiology | Current | Accepting new patients |
| Carle West Physician Group Inc | Current | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
130 Center Way
Corning, NY 14830
Phone (607) 936-9971
1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Interoperability endpoints
- smanickammd433722@carlehiedirect.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Normal, IL
- NPI 1467074138
-
- Multi-Specialty Clinic/Center
- Corning, NY
- NPI 1134178635
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Normal, IL
- NPI 1962424036
-
- General Acute Care Hospital
- Bloomington, IL
- NPI 1619916806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1013316769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 FRANKLIN AVE",
"city": "NORMAL",
"state": "IL",
"postal_code": "617613558",
"telephone_number": "309-268-5867"
}
],
"practiceLocations": [
{
"address_1": "1 Guthrie Dr",
"address_purpose": "LOCATION",
"city": "Corning",
"state": "NY",
"postal_code": "148303696",
"country_code": "US",
"telephone_number": "607-937-7200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANICKAM",
"first_name": "SARAVANAKUMAR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-19",
"last_updated": "2025-02-17",
"certification_date": "2025-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036172305",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "296525",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "msaravankumar146207@direct-guthrie.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1 Guthrie Dr",
"city": "Corning",
"state": "NY",
"country_code": "US",
"postal_code": "148303696",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.