Individual provider Active NPI

Manu Lonial, M.D.

  • Family Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1063553543
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43225 Issued in AZ
Practice address
1741 Mesquite Ave # 100
Lake Havasu City, AZ 86403-5695
Phone
(928) 782-7972
Fax
(928) 329-4522
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036113596 IL
Family Medicine Physician 207Q00000X 43225 AZ Primary

Addresses

Primary practice location

1741 Mesquite Ave # 100
Lake Havasu City, AZ 86403-5695

Mailing address

1741 Mesquite Ave # 100
Lake Havasu City, AZ 86403-5695
Phone (928) 782-7972

Other identifiers 1

IdentifierTypeStateIssuer
579940MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20110120000449 AZ Practitioner - Family Practice 0749202208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1741 Mesquite Ave
Suite 100a
Lake Havasu City, AZ 86403-5686
Phone (928) 733-6351

Hospital & facility affiliations

  • River Valley Home Health Home health agency, Lake Havasu, AZ, CCN 037402
  • Havasu Regional Medical Center Home Health Home health agency, Lake Havasu City, AZ, CCN 037057
  • Family Care Home Health Agency Home health agency, Bullhead City, AZ, CCN 037477
  • Hospice of Havasu, Inc. Hospice, Lake Havasu City, AZ, CCN 031543
  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055
  • La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC Family Medicine Current Accepting new patients
Southwest Primary Care LTD Family Medicine CurrentSince Jan 10, 2015 Accepting new patients
Good Health Medical, PLLC Family Medicine CurrentSince Oct 2, 2015 Accepting new patients
Good Health Medical, PLLC Family Medicine CurrentSince Oct 2, 2015 Accepting new patients
Park Primary Care LTD Past Accepting new patients

Locations

3200 N Dobson Rd
Ste F-5
Chandler, AZ 85224
Phone (480) 306-8790

3100 N Alma School Rd
Chandler, AZ 85224
Phone (480) 255-5983

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

1741 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 733-6351

1035 N Ellsworth Rd
Ste 108
Mesa, AZ 85207
Phone (480) 305-2888

1982 W Main St
Ste 101
Mesa, AZ 85201
Phone (480) 295-4880

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

1079 W 23rd St
Yuma, AZ 85364
Phone (928) 247-6825

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1063553543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 MESQUITE AVE # 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035695",
            "telephone_number": "928-782-7972",
            "fax_number": "928-329-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 MESQUITE AVE # 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035695",
            "telephone_number": "928-782-7972",
            "fax_number": "928-329-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONIAL",
        "first_name": "MANU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036113596",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "43225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "579940",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.