Individual provider Active NPI

Krishna N. Manvi, M.D.

  • Cardiovascular Disease Physician
  • Long Beach, CA
National Provider Identifier
1083666051
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A25713 Issued in CA
Practice address
2776 Pacific Ave
Long Beach, CA 90806-2613
Phone
(562) 595-1911
Fax
(562) 595-1911
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A25713 CA Primary

Addresses

Primary practice location

2776 Pacific Ave
Long Beach, CA 90806-2613

Mailing address

4712 E 2ND St # 533
Long Beach, CA 90803-5309
Phone (562) 342-3001

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ77353ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071128000288 CA Practitioner - Cardiovascular Disease (Cardiology) 4587753660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1962
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Krishna N. Manvi, M.D., Inc.Group PAC ID 3173550704, 2 clinicians

Practice addresses (Care Compare)

2776 Pacific Ave
Long Beach, CA 90806-2613
Phone (562) 342-3001

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • College Medical Center Hospital, Long Beach, CA, CCN 050776

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A25713CAMDCardiovascular Disease Physician

Organizations & group practices 1

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 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1083666051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 E 2ND ST # 533",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035309",
            "telephone_number": "562-342-3001",
            "fax_number": "562-342-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062613",
            "telephone_number": "562-595-1911",
            "fax_number": "562-595-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANVI",
        "first_name": "KRISHNA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A25713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ77353Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.