Individual provider Active NPI

Manohar Kuruva, M.D.

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1104267525
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME149129 Issued in FL
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322
Phone
(404) 778-4747
Fax
(404) 686-5709
NPI assigned
Jul 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 82954 GA
Neuroradiology Physician 2085N0700X 82954 GA
Student in an Organized Health Care Education/Training Program 390200000X AR
Diagnostic Radiology Physician 2085R0202X ME149129 FL Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322

Mailing address

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-4747

Other practice location 1

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-4747

Other practice location 2

4301 W Markham St
Little Rock, AR 72205-7101
Phone (501) 765-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, KY, OH4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20190723002227 GA Practitioner - Nuclear Medicine 6103142740 Reassigns benefits to 2 organizations
I20210616001508 FL Practitioner - Diagnostic Radiology 6103142740 Reassigns benefits to 5 organizations
I20221221002112 KY Practitioner - Diagnostic Radiology 6103142740 Reassigns benefits to 1 organization
I20240415001457 OH Practitioner - Diagnostic Radiology 6103142740 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians

Practice addresses (Care Compare)

211 Tortola Way
St Johns, FL 32259-1136
Phone (501) 765-7602

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027
  • Cleveland Clinic Hospital Hospital, Weston, FL, CCN 100289
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME149129FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Feb 27, 2024 Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Feb 21, 2025 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Jul 12, 2019 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Neuroradiology CurrentSince Nov 12, 2021 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Feb 27, 2024 Accepting new patients
Florida Radiology Imaging at Lake Mary LLC Neuroradiology CurrentSince Nov 12, 2021 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 12, 2019 Accepting new patients
Emory Medical Care Foundation Inc Neuroradiology CurrentSince Jul 12, 2019 Accepting new patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Feb 21, 2025 Accepting new patients

Locations

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Interoperability endpoints

  • Direct secure messaging: mkuruva58259@adventhealth.direct-ci.com

Organizations & group practices 10

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 5

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": "1373760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1104267525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-778-4747",
            "fax_number": "404-686-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30322",
            "telephone_number": "404-778-4747",
            "fax_number": "404-686-5709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30322",
            "country_code": "US",
            "telephone_number": "404-778-4747",
            "fax_number": "404-686-5709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 W Markham St",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-765-7602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURUVA",
        "first_name": "MANOHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-14",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "GA",
            "license": "82954",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "GA",
            "license": "82954",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME149129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.