Individual provider Active NPI

Manik Chowdhry, MD

  • Family Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1205564275
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351049502 Issued in MI
Practice address
1 Ascension Pkwy
Grand Blanc, MI 48439
Phone
(810) 606-5985
NPI assigned
Aug 9, 2022
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351049502 MI Primary

Addresses

Primary practice location

1 Ascension Pkwy
Grand Blanc, MI 48439

Mailing address

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5985

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL securerecords.sanford.html

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
I20220922001147 MI Order and Referring Only - Family PracticePractitioner - Family Practice 2769867001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351049502MIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mchowdhry1121085@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1205564275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5985",
            "fax_number": "810-606-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ASCENSION PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-606-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOWDHRY",
        "first_name": "MANIK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351049502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "1 Ascension Pkwy",
            "city": "Grand Blanc",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.