Individual provider Active NPI

Manisha Mittal, MD

  • Rheumatology Physician
  • Fresno, CA
National Provider Identifier
1154627776
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A126113 Issued in CA
Practice address
2475 E Fir Ave Ste 104
Fresno, CA 93720-0398
Phone
(559) 900-4013
Fax
(559) 900-4172
NPI assigned
Jan 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X A126113 CA Primary

Addresses

Primary practice location

2475 E Fir Ave Ste 104
Fresno, CA 93720-0398

Mailing address

7045 N Maple Ave Ste 101
Fresno, CA 93720-8008
Phone (559) 493-1900

Other names 1

  • Manisha Sharma Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140128001320 CA Practitioner - RheumatologyPractitioner - Internal Medicine 5395974174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vivek Mittal MD and Manisha Mittal MD IncGroup PAC ID 7618247966, 2 clinicians

Practice addresses (Care Compare)

2475 E Fir Ave
Fresno, CA 93720-0398
Phone (559) 900-4013

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126113CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vivek Mittal, M.D. and Manisha Mittal, M.D. Inc. CurrentSince Jul 1, 2017 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

7045 N Maple Ave
Ste 101
Fresno, CA 93720
Phone (559) 326-7393

2475 E Fir Ave
Ste 104
Fresno, CA 93720
Phone (559) 900-0413

Organizations & group practices 2

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 1

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": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1154627776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 N MAPLE AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208008",
            "telephone_number": "559-493-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 E FIR AVE STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200398",
            "telephone_number": "559-900-4013",
            "fax_number": "559-900-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "MANISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-28",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A126113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANISHA",
            "last_name": "SHARMA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.