Individual provider Active NPI

Vishnu Raj Kumar Mani, M.D.

  • Surgery Physician
  • Rockford, IL
National Provider Identifier
1174964951
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D91124 Issued in MD
Practice address
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone
(815) 971-4066
NPI assigned
Jul 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD-50213 IA
Surgery Physician 208600000X 036161994 IL
Surgical Critical Care Physician 2086S0102X MD-50213 IA
Surgical Critical Care Physician 2086S0102X 036161994 IL
Trauma Surgery Physician 2086S0127X MD-50213 IA
Trauma Surgery Physician 2086S0127X 036161994 IL
Surgery Physician 208600000X D91124 MD Primary

Addresses

Primary practice location

8201 E Riverside Blvd
Rockford, IL 61114-2300

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-7892

Other practice location 1

220 S Park Ave Fl 3
Herrin, IL 62948-3602
Phone (618) 942-2002

Other practice location 2

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

Other practice location 3

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6278

Other practice location 4

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-7892

Other practice location 5

305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone (618) 457-3006

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address vmani63235@sih.direct-ci.com
Direct Messaging Address vmani63235@sih.direct-ci.com
Direct Messaging Address vmani492837@direct-ehr-ssmhc.com Direct
FHIR URL FHIR-API Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221016000028 IL Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3476956095 Reassigns benefits to 4 organizations
I20241009003127 WI Practitioner - General Surgery 3476956095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
  • Javon Bea Hospital Hospital, Rockford, IL, CCN 140239
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D91124MDMDSurgery Physician
MD-50213IAMDSurgical Critical Care Physician
036161994ILMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Nov 1, 2022 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. Surgery CurrentSince Oct 2, 2023 Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 27, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 27, 2024 Accepting new patients
Southern Illinois Medical Services, NFP PastSince Nov 1, 2022 Accepting new patients

Locations

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

220 S Park Ave
Fl 3
Herrin, IL 62948
Phone (618) 942-2002

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

8600 State Route 91
Ste 330
Peoria, IL 61615
Phone (309) 308-2010

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: vmani492837@direct-ehr-ssmhc.com
  • Direct secure messaging: vmani63235@sih.direct-ci.com
  • Direct secure messaging: vmani857355@direct.hopkinsmedicine.org
  • Direct secure messaging: vmani250890@uihcdirect.org

Organizations & group practices 9

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 3

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": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1174964951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-7892",
            "fax_number": "319-356-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611142300",
            "telephone_number": "815-971-4066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 S Park Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483602",
            "country_code": "US",
            "telephone_number": "618-942-2002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Good Samaritan Way",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628642402",
            "country_code": "US",
            "telephone_number": "618-242-4600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482940",
            "country_code": "US",
            "telephone_number": "608-756-6278",
            "fax_number": "608-756-6289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-7892",
            "fax_number": "319-356-3692",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Jackson St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANI",
        "first_name": "VISHNU RAJ KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "MD-50213",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036161994",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IA",
            "license": "MD-50213",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036161994",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IA",
            "license": "MD-50213",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036161994",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D91124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vmani63235@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "220 S Park Ave Fl 3",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vmani63235@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vmani492837@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "vmani492837@direct-ehr-ssmhc.com",
            "address_1": "1 Good Samaritan Way",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "FHIR-API",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1 Good Samaritan Way",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.