Kannan Manickam, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

01056563A Issued in IN

Practice address

6820 Hospital Dr
Suite 210
Baltimore, MD 21237-4352

Phone

(410) 391-6131

Fax

(410) 391-6144

NPI assigned

Jul 29, 2005

Last updated

May 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Urology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Rosedale, MD, CCN 217094
• Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
• Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kannanmanickam@tsicua.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chesapeake Urology Associates, LLC

  dba Chesapeake Oncology Hematology Associates

  • Hematology & Oncology Physician
  • Stevensville, MD
  • NPI 1467337337
  Medicare reassignment Care Compare group NPD
• Chesapeake Urology Associates LLC

  • Urology Physician
  • Owings Mills, MD
  • NPI 1609823004
  NPD
• Chesapeake Urology Associates, LLC

  • Urology Physician
  • Seaford, DE
  • NPI 1043719123
  NPD (past)
• Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
  • NPI 1508075680

  Urology

  NPD (past)
• Urology Associates of Northwest Indiana PC

  • Urology Physician
  • Valparaiso, IN
  • NPI 1780750133
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Maryland LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Rosedale, MD
  • NPI 1548229834
  Care Compare affiliation Name & address match
• Franklin Square Hospital Center, Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1184712085
  Care Compare affiliation
• Upper Chesapeake Medical Center, Inc.

  dba UM Upper Chesapeake Medical Center at Aberdeen

  • General Acute Care Hospital
  • Bel Air, MD
  • NPI 1598761355
  Care Compare affiliation

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1023018074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "410-581-1600",
            "fax_number": "410-581-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 HOSPITAL DR",
            "address_2": "SUITE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374352",
            "telephone_number": "410-391-6131",
            "fax_number": "410-391-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANICKAM",
        "first_name": "KANNAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01056563A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richa Manglorkar
• Ciera Mangone, MD
• Kimberley Mangus, PA-C
• Beletiah Mani
• Romil Hemal Maniar, MD
• Manifest Recovery, LLC
• Manifest Recovery, LLC
• Divya Manikandan
• Gowrishankar Manimaran, MD
• Nelson Daniel Maniscalco, D.P.M.

• Urology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Urology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.