Individual provider Active NPI

Shanthi Manivannan, M. D.

  • Internal Medicine Physician
  • Morgantown, WV
National Provider Identifier
1235242561
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19516 Issued in WV
Practice address
1 Stadium Drive
Morgantown, WV 26506
Phone
(304) 598-4800
Fax
(304) 293-6963
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19516 WV Primary

Addresses

Primary practice location

1 Stadium Drive
Morgantown, WV 26506

Mailing address

P. O. Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
0082277000MedicaidWV

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address smanivannan565@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address smanivannan565@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address smanivannan565@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050920000484 WV Practitioner - Internal Medicine 7719911726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

Hospital & facility affiliations

  • Care Partners Home Health Home health agency, Westover, WV, CCN 517100
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19516WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Education Building CurrentSince Aug 1, 1998 Accepting new patients
West Virginia University Medical Corporation Internal Medicine Current Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 1, 1998 Accepting new patients
West Virginia University Hospitals, Inc Past Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

6040 University Town Centre Dr
Morgantown, WV 26501

930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299

Interoperability endpoints

  • Direct secure messaging: smanivannan565@direct.wvuhsdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1235242561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 897",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070897",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4800",
            "fax_number": "304-293-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIVANNAN",
        "first_name": "SHANTHI",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "19516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082277000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smanivannan565@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smanivannan565@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smanivannan565@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.