Individual provider Active NPI

Manisha Chaturvedi, MD

  • Family Medicine Physician
  • De Pere, WI
National Provider Identifier
1023329042
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60701 Issued in WI
Practice address
1881 Chicago St
De Pere, WI 54115-3770
Phone
(920) 403-8000
NPI assigned
Jun 24, 2010
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 60701 WI Primary

Addresses

Primary practice location

1881 Chicago St
De Pere, WI 54115-3770

Mailing address

1881 Chicago St
De Pere, WI 54115-3770
Phone (920) 403-8000

Other identifiers 1

IdentifierTypeStateIssuer
100033121MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mchaturvedi90521@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20131107001224 WI Practitioner - Family Practice 1355583899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

1881 Chicago St
De Pere, WI 54115-3770
Phone (920) 403-8000

2253 W Mason St
Green Bay, WI 54303-4706
Phone (920) 327-7300

980 S Saint Augustine St
Pulaski, WI 54162-9453
Phone (920) 822-7700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60701WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2013 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2013 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1881 Chicago St
De Pere, WI 54115
Phone (920) 403-8000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: mchaturvedi90521@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1023329042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 CHICAGO ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541153770",
            "telephone_number": "920-403-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 CHICAGO ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541153770",
            "telephone_number": "920-403-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATURVEDI",
        "first_name": "MANISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "60701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100033121",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchaturvedi90521@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1881 Chicago St",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541153770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1881 Chicago St",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541153770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.