Individual provider Active NPI

Manonitha Jayaweera, M.D.

  • Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1154412500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35082525 Issued in OH
Practice address
1708 Southpoint Dr
Cleveland, OH 44109-1911
Phone
(216) 787-0500
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35082525 OH Primary

Addresses

Primary practice location

1708 Southpoint Dr
Cleveland, OH 44109-1911

Mailing address

30 E Broad St
11TH FL. Attn: Tonya Fasone
Columbus, OH 43215-3414
Phone (614) 466-9930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040820000570 OH Practitioner - Psychiatry 2668446212 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35082525OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince May 1, 2011 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince May 1, 2011 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients

Locations

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

1756 Sagamore Rd
Northfield, OH 44067
Phone (330) 467-7131

1756 Sagamore Rd
Rm 312
Northfield, OH 44067

Interoperability endpoints

  • Direct secure messaging: mjayaweera19484@mhas.direct-ci.com

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154412500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E BROAD ST",
            "address_2": "11TH FL. ATTN: TONYA FASONE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153414",
            "telephone_number": "614-466-9930",
            "fax_number": "614-644-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 SOUTHPOINT DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091911",
            "telephone_number": "216-787-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYAWEERA",
        "first_name": "MANONITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35082525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.