Vivek K Manchanda, MD

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

2006017511 Issued in MO

Practice address

4122 Keaton Crossing Blvd
Suite 102
O Fallon, MO 63368-8218

Phone

(636) 329-9077

Fax

(636) 329-9076

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

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 2

Specialty

AnesthesiologyAlso: Pain Management

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carroll County Memorial HospitalGroup PAC ID 2860485638, 64 clinicians

Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Pike County Memorial HospitalGroup PAC ID 8123015518, 31 clinicians

Washington County Memorial HospitalGroup PAC ID 3476456880, 22 clinicians

Madison Medical Center Stockhoff Memorial Nursing HomeGroup PAC ID 1355255886, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311
• Fayette County Hospital Hospital, Vandalia, IL, CCN 141346
• Carroll County Memorial Hospital Hospital, Carrollton, MO, CCN 261332
• Madison Medical Center Hospital, Fredericktown, MO, CCN 261302
• Pike County Memorial Hospital Hospital, Louisiana, MO, CCN 261333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJJCCA/Endpoint/BJJCCA

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.

• Elpis Pain Management Center LLC

  • Pain Medicine Physician
  • O Fallon, MO
  • NPI 1841544251

  Anesthesiology, MO

  Medicare reassignment NPD Authorized official
• Madison Medical Center Stockhoff Memorial Nursing Home

  • Critical Access Hospital
  • Fredericktown, MO
  • NPI 1720163025

  MO

  Medicare reassignment Care Compare group NPD
• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158

  MO

  Medicare reassignment Care Compare group NPD
• Pike County Memorial Hospital

  • Rural Health Clinic/Center
  • Louisiana, MO
  • NPI 1437265311

  MO

  Medicare reassignment Care Compare group NPD
• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821

  MO

  Medicare reassignment Care Compare group NPD
• Carroll County Memorial Hospital

  • Critical Access Hospital
  • Carrollton, MO
  • NPI 1528067113

  MO

  Medicare reassignment Care Compare group
• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662

  IL

  Medicare reassignment NPD
• Mercy Hospital Perry

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1639858855
  Care Compare group NPD
• Pike County Memorial Hospital

  • Rural Health Clinic/Center
  • Bowling Green, MO
  • NPI 1134633456
  Care Compare group NPD
• Elpis Healthcare Inc

  • Pain Clinic/Center
  • Saint Louis, MO
  • NPI 1841540382
  NPD (past) Authorized official
• Madison Medical Center Stockhoff Memorial Nursing Home

  • Rural Health Clinic/Center
  • Fredericktown, MO
  • NPI 1467539031
  Care Compare group NPD (past)
• Mercy Hospital Perry

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1215613880
  Care Compare group NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carroll County Memorial Hospital

  • Critical Access Hospital
  • Carrollton, MO
  • NPI 1528067113

  Hospital

  Care Compare affiliation
• Madison Medical Center Stockhoff Memorial Nursing Home

  • Critical Access Hospital
  • Fredericktown, MO
  • NPI 1720163025

  Hospital

  Care Compare affiliation
• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158

  Hospital

  Care Compare affiliation
• Pike County Memorial Hospital

  • Critical Access Hospital
  • Louisiana, MO
  • NPI 1205837218

  Hospital

  Care Compare affiliation
• Sarah Bush Lincoln Health Center

  • Critical Access Hospital
  • Vandalia, IL
  • NPI 1912988734

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430006400000",
    "number": "1083729941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 KEATON CROSSING BLVD",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688218",
            "telephone_number": "636-329-9077",
            "fax_number": "636-329-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 KEATON CROSSING BLVD",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688218",
            "telephone_number": "636-329-9077",
            "fax_number": "636-329-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHANDA",
        "first_name": "VIVEK",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2006017511",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MO",
            "license": "2006017511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER PTAN",
            "identifier": "P01433382",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN , MEDICARE DME",
            "identifier": "7233350001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00836305",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083729941",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Elizabeth Malloy, RDN, LDN
• Gerard J Malnar, M.D.
• Megan Malone, D.C.
• Miranda Dawn Malone, LE, LTA
• Autumn Chase Rosalia Maloney, DMD
• Tom Joseph Mann, RNFA
• Brian C Manning, MPT
• Jordan Marcinczyk
• Paul Richard Marion, PLPC
• John Marshall III, DMD

• All providers in O Fallon, MO
• Pain Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2015; 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.

Verify at the official NPI Registry.