Maneesha T Joseph, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.008939 Issued in IL

Practice address

1302 Franklin Ave
Suite 3400
Normal, IL 61761-3551

Phone

(309) 556-8300

Fax

(309) 556-8295

NPI assigned

Oct 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Maneesha T Poulose Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment Care Compare group
• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  NPD (past)

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

• Carle Bromenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  Care Compare affiliation

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1033494455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "address_2": "SUITE 3400",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-556-8300",
            "fax_number": "309-556-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "address_2": "SUITE 3400",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-556-8300",
            "fax_number": "309-556-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "MANEESHA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "IL",
            "license": "041.394485",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "582593-1",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "FL",
            "license": "RN 9300306",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336606-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.008939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANEESHA",
            "last_name": "POULOSE",
            "middle_name": "T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Jones, CST-A
• Roy Jones, RPH
• Ali Marie Joos, APRN, CNP
• David Jordan, FNP
• Natalie Louise Jordan, APRN,CNP
• Joyful Care Connections, LLC
• Ralph Edward Saballa Junquera, PT
• Arvind Kalyan Sundaram, MD
• Juliana R. Kaminski, D.O.
• Evan Kapanga, MD

• Family Nurse Practitioner in Normal, IL
• Providers in Normal, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.