Individual provider Active NPI

Jared K. Manwaring, MD

  • Urology Physician
  • Idaho Falls, ID
National Provider Identifier
1235573148
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M-14260 Issued in ID
Practice address
2375 Coronado St
Idaho Falls, ID 83404-7407
Phone
(208) 552-1234
Fax
(208) 529-1948
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X M-14260 ID Primary

Addresses

Primary practice location

2375 Coronado St
Idaho Falls, ID 83404-7407

Mailing address

2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20180824002609 ID Practitioner - Family Practice 1456600386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

2351 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-7310

2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-4823

2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

380 Walker Dr
Rexburg, ID 83440-1657
Phone (208) 356-9559

Hospital & facility affiliations

  • Aspen Home Health Services Home health agency, Idaho Falls, ID, CCN 137081
  • Enhabit Home Health of Eastern Idaho Home health agency, Idaho Falls, ID, CCN 137105
  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074
  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
  • Teton Valley Hospital Hospital, Driggs, ID, CCN 131313
  • Steele Memorial Medical Center Hospital, Salmon, ID, CCN 131305

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-14260IDMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
MVH BMC LLC CurrentSince Jul 7, 2019 Accepting new patients
MVH BMC LLC Single Specialty CurrentSince Jul 7, 2019 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

1441 Parkway Dr
Blackfoot, ID 83221
Phone (208) 785-2600

2375 Coronado St
Idaho Falls, ID 83404
Phone (208) 522-4600

2235 E 25th St
Idaho Falls, ID 83404
Phone (208) 521-7593

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770

210 S Emerson Ave
Shelley, ID 83274
Phone (208) 357-7404

Interoperability endpoints

  • Direct secure messaging: jaredk.manwaring@synapse.cernerdirect.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 7

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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1235573148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-552-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-552-1234",
            "fax_number": "208-529-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANWARING",
        "first_name": "JARED",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "ID",
            "license": "M-14260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.