Individual provider Active NPI

Mahendra Singh Panesar, M.D.

  • Pediatrics Physician
  • Manchester, NH
National Provider Identifier
1104894708
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
013589 Issued in ME
Practice address
Pediatric Health Associates
275 Mammoth Road, Suite 1
Manchester, NH 03109
Phone
(603) 663-8350
Fax
(603) 663-8399
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 013589 ME Primary
Pediatrics Physician 208000000X 13509 NH

Addresses

Primary practice location

Pediatric Health Associates
275 Mammoth Road, Suite 1
Manchester, NH 03109

Mailing address

Pediatric Health Associates
275 Mammoth Road, Suite 1
Manchester, NH 03109
Phone (603) 663-8350

Other identifiers 1

IdentifierTypeStateIssuer
13509OtherNHNH LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20101110000857 NH Practitioner - Pediatric Medicine 4082809512 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013589MEMDPediatrics Physician
13509NHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network Pediatrics CurrentSince Sep 6, 2010 Accepting new patients

Locations

4 Elliot Way
Ste 105
Manchester, NH 03103
Phone (603) 626-5113

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

275 Mammoth Rd
Manchester, NH 03109
Phone (603) 663-8300

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1104894708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEDIATRIC HEALTH ASSOCIATES",
            "address_2": "275 MAMMOTH ROAD, SUITE 1",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03109",
            "telephone_number": "603-663-8350",
            "fax_number": "603-663-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEDIATRIC HEALTH ASSOCIATES",
            "address_2": "275 MAMMOTH ROAD, SUITE 1",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03109",
            "telephone_number": "603-663-8350",
            "fax_number": "603-663-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANESAR",
        "first_name": "MAHENDRA",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "013589",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "13509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH LICENSE",
            "identifier": "13509",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.