Individual provider Active NPI

Michelle Ann Manalang, M.D.

  • Pediatric Hematology & Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1043227184
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
2003013583 Issued in MO
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-5940
Fax
(612) 813-6325
NPI assigned
Aug 2, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 67612 WI
Pediatric Hematology & Oncology Physician 2080P0207X 2003013583 MO Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2530 Chicago Ave # Csc175
Minneapolis, MN 55404-4289
Phone (612) 813-5940

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170818002365 WI Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 9335148337 Reassigns benefits to 2 organizations
I20260609002334 MN Practitioner - Hematology/Oncology 9335148337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5901 Lincolin Dr
Edina, MN 55436-1611

5901 Lincoln Dr CBC 2 Rev/Pe
Edina, MN 55436-1611

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67612WIMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 21, 2017 Accepting new patients
Childrens Health Care Past Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

Interoperability endpoints

  • Direct secure messaging: michelle.manalang@hca3.eclinicaldirectplus.com
  • Direct secure messaging: michelle.manalang@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1043227184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE # CSC175",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-5940",
            "fax_number": "612-813-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-5940",
            "fax_number": "612-813-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANALANG",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WI",
            "license": "67612",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MO",
            "license": "2003013583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.