Individual provider Active NPI

Manjusha Gunuganti

  • Physical Medicine & Rehabilitation Physician
  • San Antonio, TX
National Provider Identifier
1043243595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
M2966 Issued in TX
Practice address
111 Dallas St
San Antonio, TX 78205-1201
Phone
(210) 618-6623
NPI assigned
Jul 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X M2966 TX Primary

Addresses

Primary practice location

111 Dallas St
San Antonio, TX 78205-1201

Mailing address

20770 Hwy 281 No.,
108-492
San Antonio, TX 78258-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060407000411 TX Practitioner - Physical Medicine and Rehabilitation 4789693417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20770 N Hwy 281
108 492
San Antonio, TX 78258-7655
Phone (210) 366-9906

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M2966TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Physical Medicine and Rehabilitation Clinics PA Physical Medicine & Rehabilitation CurrentSince Feb 1, 2010 Accepting new patients
Alasdair Goldstein MD PA Past Accepting new patients

Locations

20770 US Highway 281 N
San Antonio, TX 78258
Phone (210) 366-9906

Organizations & group practices 2

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 4

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043243595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20770 HWY 281 NO.,",
            "address_2": "108-492",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DALLAS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051201",
            "telephone_number": "210-618-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNUGANTI",
        "first_name": "MANJUSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "M2966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.