Manoucher Jalali, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD036214L Issued in PA

Practice address

2211 Chichester Ave
Suite 102
Boothwyn, PA 19061

Phone

(610) 494-3911

Fax

(610) 497-5047

NPI assigned

Jul 7, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Practice roles

Locations

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.

• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment
• Prospect Health Access Network, Inc.

  • Surgery Physician
  • Chester, PA
  • NPI 1922455443
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033141171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 CHICHESTER AVE",
            "address_2": "SUITE 102",
            "city": "BOOTHWYN",
            "state": "PA",
            "postal_code": "19061",
            "telephone_number": "610-494-3911",
            "fax_number": "610-497-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 CHICHESTER AVE",
            "address_2": "SUITE 102",
            "city": "BOOTHWYN",
            "state": "PA",
            "postal_code": "19061",
            "telephone_number": "610-494-3911",
            "fax_number": "610-497-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALALI",
        "first_name": "MANOUCHER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD036214L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007580360002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Gregory Horsky II, D.C.
• Glenn Eugene Horsky, D.C.
• Beth A. Howlett, PH.D.
• IHS Acquisition XXX, Inc. (US Bioservices)
• Fadi Iskander, OD
• Jeff Quip, Inc. (The Home Care Network, Jefferson Health System - Rehab Equipment)
• Joel S. Goldberg
• Nancy Elizabeth Jordan, PT
• Manuel T. Lim, MD
• Issam Malkoun, OPTICIAN

• Surgery Physician in Boothwyn, PA
• Providers in Boothwyn, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.