Individual provider Active NPI

Obli Chetty Maragatha Mani, MD

  • Family Medicine Physician
  • Quincy, MA
National Provider Identifier
1174584908
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
234649 Issued in MA
Practice address
1250 Hancock St
Internal Medicine
Quincy, MA 02169-4339
Phone
(617) 774-0840
Fax
(617) 774-0882
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A89147 CA
Family Medicine Physician 207Q00000X 234649 MA Primary

Addresses

Primary practice location

1250 Hancock St
Internal Medicine
Quincy, MA 02169-4339

Mailing address

1250 Hancock St
Internal Medicine
Quincy, MA 02169-4339
Phone (617) 774-0840

Other identifiers 2

IdentifierTypeStateIssuer
00A891470MedicaidCA
2161117MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address omanimd20692@direct.atrius.masshiway.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20081105000594 MA Practitioner - Internal Medicine 9234184870

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

147 Milk St
Boston, MA 02109-4806

147 Milk St
Boston, MA 02109-4862

Hospital & facility affiliations

  • South Shore Visiting Nurse Association Home health agency, Rockland, MA, CCN 227082
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Oct 1, 2008 Accepting new patients
Atrius Health, Inc. CurrentSince Oct 1, 2008 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

1250 Hancock St
Quincy, MA 02169
Phone (617) 774-0600

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.

Hospital & facility affiliations 2

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1174584908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK ST",
            "address_2": "INTERNAL MEDICINE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694339",
            "telephone_number": "617-774-0840",
            "fax_number": "617-774-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK ST",
            "address_2": "INTERNAL MEDICINE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694339",
            "telephone_number": "617-774-0840",
            "fax_number": "617-774-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANI",
        "first_name": "OBLI",
        "middle_name": "CHETTY MARAGATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A89147",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "234649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A891470",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161117",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omanimd20692@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "1250 Hancock St",
            "address_2": "Internal Medicine",
            "city": "Quincy",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021694339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.