Manjula S Mangipudy, MD

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

ME038891 Issued in FL

Practice address

205 Dr Martin Luther King Jr St N
Suite 419
St Petersburg, FL 33701-3109

Phone

(727) 820-4231

Fax

(727) 820-4231

NPI assigned

Oct 6, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pinellas County Health Department

  • Ambulatory Family Planning Facility
  • Saint Petersburg, FL
  • NPI 1457458838
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1053408492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HARBOUR ISLAND BLVD",
            "address_2": "UNIT 819",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025712",
            "telephone_number": "813-472-9505",
            "fax_number": "813-472-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 DR MARTIN LUTHER KING JR ST N",
            "address_2": "SUITE 419",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013109",
            "telephone_number": "727-820-4231",
            "fax_number": "727-820-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIPUDY",
        "first_name": "MANJULA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "ME038891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058380400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Maltezos, PMHNP
• Justin Mandel, L.AC
• Steven Mark Mandel, M.D.
• Deja Mandy, APRN
• Mona Vishin Mangat, MD
• Rhoderick James Manhattan, PA-C
• Gina Lisa Maniaci, LCSW
• Shane Manion
• Jennifer Leah Maniscalco, MD
• Manishi G Mukherjee MD PA

• Adolescent Medicine (Family Medicine) Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Adolescent Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.