Active NPI
Kurmanath Manyam, M.D.
- Anesthesiology Physician
- Pontiac, MI
National Provider Identifier
1124134242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301053092
- Practice address
- 461 W Huron St
Pontiac, MI 48341-1601 - Phone
- (248) 857-7200
- NPI assigned
- Aug 22, 2006
- Last updated
- May 13, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | KM053092 | MI | |
| Specialist | 174400000X | 4301053092 | MI | |
| Anesthesiology Physician | 207L00000X | 4301053092 | MI | Primary |
Addresses
Primary practice location
461 W Huron St
Pontiac, MI 48341-1601
Mailing address
3005 Croft Way
Bloomfield Hills, MI 48302-1180
Phone (810) 610-2809
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KM053092 | MI | MD | Specialist |
| 4301053092 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakland Physicians Medical Center | Past | Accepting new patients | |
| North Oakland ASC LLC | Past | Accepting new patients | |
| Oakland Anesthesia Care Associates PLLC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ambulatory Surgical Clinic/Center
- Waterford, MI
- NPI 1942393475
-
- Anesthesiology Physician
- Pontiac, MI
- NPI 1962653238
-
dba Doctors' Hospital of Michigan
- Urgent Care Clinic/Center
- Waterford, MI
- NPI 1366739815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1124134242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3005 CROFT WAY",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483021180",
"telephone_number": "810-610-2809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 W HURON ST",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411601",
"telephone_number": "248-857-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANYAM",
"first_name": "KURMANATH",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "KM053092",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "4301053092",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301053092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.