Individual provider Active NPI

Sandhya Devi Mani, M.D.

  • Pediatric Allergy/Immunology Physician
  • Baton Rouge, LA
National Provider Identifier
1205026770
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
026439 Issued in LA
Practice address
8200 Constantin Blvd FL 3
Baton Rouge, LA 70809-3481
Phone
(225) 765-5500
Fax
(225) 374-1672
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD026439 LA
Internal Medicine Physician 207R00000X 026439 LA
Pediatrics Physician 208000000X 026439 LA
Pediatric Allergy/Immunology Physician 2080P0201X 026439 LA Primary

Addresses

Primary practice location

8200 Constantin Blvd FL 3
Baton Rouge, LA 70809-3481

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other practice location 1

7777 Hennessy Blvd
Suite 408
Baton Rouge, LA 70808-4300
Phone (225) 765-6834

Other practice location 2

8200 Constantin Blvd Fl 3
Baton Rouge, LA 70809-3481
Phone (225) 765-5500

Other identifiers 1

IdentifierTypeStateIssuer
1065439MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smani2768@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20090724000693 LA Practitioner - Allergy/ImmunologyPractitioner - Internal MedicinePractitioner - Pediatric Medicine 9830242783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine, Pediatric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

1937 S Burnside Ave
Gonzales, LA 70737-4632
Phone (225) 765-5500

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD026439LAMDAllergy & Immunology Physician
026439LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 1, 2012 Accepting new patients
Our Lady of the Lake Physician Group LLC Allergy & Immunology Current Accepting new patients
Louisiana Ear, Nose, Throat & Sinus, LLC CurrentSince Mar 1, 2023 Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Jul 1, 2012 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Fyzical of Baton Rouge, LLC Past Accepting new patients

Locations

8080 Bluebonnet Blvd
Ste 2222
Baton Rouge, LA 70810
Phone (225) 408-6900

8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806
Phone (225) 765-4226

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8200 Constantin Blvd
Fl 3
Baton Rouge, LA 70809
Phone (225) 765-1982

8200 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1610

1931 S Burnside Ave
Gonzales, LA 70737
Phone (225) 647-7246

1937 S Burnside Ave
Gonzales, LA 70737
Phone (225) 647-1947

5000 Odonavan Blvd
Ste 404
Walker, LA 70785
Phone (225) 369-8100

Interoperability endpoints

  • Direct secure messaging: smani2768@direct.casso.us.com

Organizations & group practices 6

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1205026770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 CONSTANTIN BLVD FL 3",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093481",
            "telephone_number": "225-765-5500",
            "fax_number": "225-374-1672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Hennessy Blvd",
            "address_2": "Suite 408",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084300",
            "country_code": "US",
            "telephone_number": "225-765-6834",
            "fax_number": "225-765-4378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8200 Constantin Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093481",
            "country_code": "US",
            "telephone_number": "225-765-5500",
            "fax_number": "225-374-1672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANI",
        "first_name": "SANDHYA",
        "middle_name": "DEVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "LA",
            "license": "MD026439",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "026439",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "026439",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "LA",
            "license": "026439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1065439",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smani2768@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "smani2768@direct.casso.us.com",
            "address_1": "8200 Constantin Blvd Fl 3",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8200 Constantin Blvd Fl 3",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.