Individual provider Active NPI

Palani Sudra Mani, MD

  • General Practice Physician
  • Del Rio, TX
National Provider Identifier
1063474609
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G2093 Issued in TX
Practice address
913 S Main St
Del Rio, TX 78840-5807
Phone
(830) 774-5534
Fax
(830) 774-0890
NPI assigned
Apr 6, 2006
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G2093 TX Primary

Addresses

Primary practice location

913 S Main St
Del Rio, TX 78840-5807

Mailing address

PO Box 1470
Eagle Pass, TX 78853-1470
Phone (830) 773-8917

Other identifiers 1

IdentifierTypeStateIssuer
1381659-36MedicaidTX

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
I20040406000604 TX Practitioner - General PracticePractitioner - Emergency Medicine 5597758599 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Centers CurrentSince May 21, 2007 Accepting new patients
United Medical Centers General Practice CurrentSince May 21, 2007 Accepting new patients
Stonewall Memorial Hospital Emergency Medicine Past Accepting new patients
Stonewall Memorial Hospital Past Accepting new patients
Hospital Group of South Jersey, PC Past Accepting new patients
Seminole Hospital District of Gaines County Texas Emergency Medicine Past Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients

Locations

913 S Main St
Del Rio, TX 78840
Phone (830) 774-5534

2525 N Veterans Blvd
Eagle Pass, TX 78852
Phone (830) 773-5358

Interoperability endpoints

  • Direct secure messaging: pmani.umc@umc.directbygreenway.com

Organizations & group practices 7

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1063474609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1470",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788531470",
            "telephone_number": "830-773-8917",
            "fax_number": "830-773-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 S MAIN ST",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788405807",
            "telephone_number": "830-774-5534",
            "fax_number": "830-774-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANI",
        "first_name": "PALANI",
        "middle_name": "SUDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "G2093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1381659-36",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Rio, TX

Sources for this page

Verify at the official NPI Registry.