Individual provider Active NPI

Manish Sharma, M.D.

  • Internal Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1194836858
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301059313 Issued in MI
Practice address
601 John St
Kalamazoo, MI 49007-5341
Phone
(269) 341-8481
Fax
(269) 341-7781
NPI assigned
Aug 31, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301059313 MI Primary
Nuclear Medicine Physician 207U00000X 4301059313 MI

Addresses

Primary practice location

601 John St
Kalamazoo, MI 49007-5341

Mailing address

601 John St
Kalamazoo, MI 49007-5341
Phone (269) 341-8481

Other identifiers 2

IdentifierTypeStateIssuer
1194836858MedicaidMI
110F364771OtherMIBCBS GROUP PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040108001092 MI Practitioner - Internal MedicinePractitioner - Diagnostic Radiology 4880594704 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301059313MIMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital Internal Medicine Current Accepting new patients
Bronson Methodist Hospital CurrentSince Nov 1, 2015 Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Bronson Lakeview Hospital CurrentSince Nov 1, 2015 Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
#67
Kalamazoo, MI 49007
Phone (269) 341-6022

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1194836858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8481",
            "fax_number": "269-341-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8481",
            "fax_number": "269-341-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "MANISH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301059313",
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MI",
            "license": "4301059313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194836858",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "110F364771",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.