Active NPI
Debra B Balliram Manohalal, D.O.
- Obstetrics & Gynecology Physician
- Wellington, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- OS10052
- Practice address
- 1447 Medical Park Blvd
Suite 300
Wellington, FL 33414-3164 - Phone
- (561) 790-5990
- Fax
- (561) 790-5952
- NPI assigned
- Nov 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | OS10052 | FL | Primary |
Addresses
Primary practice location
1447 Medical Park Blvd
Suite 300
Wellington, FL 33414-3164
Mailing address
770 Northpoint Parkway
Suite 102
West Palm Beach, FL 33407
Phone (561) 275-7604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 280386100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
345 Jupiter Lakes Blvd
Suite 200
Jupiter, FL 33458-7100
Phone (561) 741-1957
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.76 of 100
- Quality
- 84.84
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.7
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles (2 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Woman Care, LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Womencare PA | Past | Accepting new patients |
Locations
2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233
345 Jupiter Lakes Blvd
Ste 200
Jupiter, FL 33458
Phone (561) 741-1957
2979 Pga Blvd
Ste 100
Palm Beach Gardens, FL 33410
Phone (561) 627-6801
1447 Medical Park Blvd
Ste 205
Wellington, FL 33414
Phone (561) 234-6599
1447 Medical Park Blvd
Ste 300
Wellington, FL 33414
Phone (561) 790-5990
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- debra.balliram-manohalal.1@13043.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1386823243
-
- Specialist
- Orlando, FL
- NPI 1366529042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506297600000",
"number": "1053590489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 NORTHPOINT PARKWAY",
"address_2": "SUITE 102",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "33407",
"telephone_number": "561-275-7604",
"fax_number": "561-802-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1447 MEDICAL PARK BLVD",
"address_2": "SUITE 300",
"city": "WELLINGTON",
"state": "FL",
"postal_code": "334143164",
"telephone_number": "561-790-5990",
"fax_number": "561-790-5952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLIRAM MANOHALAL",
"first_name": "DEBRA",
"middle_name": "B",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-01",
"last_updated": "2017-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "OS10052",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "280386100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wellington, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.