Individual provider Active NPI

Manasa Gunturu, MD

  • Neurology Physician
  • Jackson, MS
National Provider Identifier
1174937148
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
26620 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216
Phone
(601) 984-5500
NPI assigned
Jun 17, 2014
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuro-ophthalmology Physician 207WX0109X 26620 MS
Neurology Physician 2084N0400X 910-L MS
Neurology Physician 2084N0400X 26620 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216

Mailing address

2500 N State St
Cbo-Suite 4200
Jackson, MS 39216-4500
Phone (601) 984-5500

Other practice location 1

2500 N State St
Jackson, MS 39216
Phone (601) 984-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20190805001638 MS Practitioner - Neurology 4880919109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
910-LMSMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2019 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2019 Accepting new patients
University of Miami Past Accepting new patients

Locations

1010 Lakeland Pl
Flowood, MS 39232
Phone (601) 815-0600

2550 Flowood Dr
Ste 200
Flowood, MS 39232
Phone (601) 936-0927

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
#4200
Jackson, MS 39216

764 Lakeland Dr
Jackson, MS 39216
Phone (601) 982-0611

Interoperability endpoints

  • Direct secure messaging: mgunturu39328@ummc.direct-ci.com

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.

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1174937148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "CBO-SUITE 4200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "39216",
            "country_code": "US",
            "telephone_number": "601-984-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNTURU",
        "first_name": "MANASA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "MS",
            "license": "26620",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "910-L",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "26620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.