Michael Manakas, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02000642 Issued in IN

Practice address

2421 Laporte Ave
Valparaiso, IN 46383-6914

Phone

(219) 462-6192

Fax

(219) 464-2585

NPI assigned

Jul 1, 2005

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 2, 2013.

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1023015385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-528-4284",
            "fax_number": "317-865-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 LAPORTE AVE",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463836914",
            "telephone_number": "219-462-6192",
            "fax_number": "219-464-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAKAS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02000642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM TRADITIONAL",
            "identifier": "000000721918",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100434540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Valparaiso, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.