Individual provider Active NPI

Raaid Hassan Mannaa Mannah, MD

  • Internal Medicine Physician
  • Deland, FL
National Provider Identifier
1255507117
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME109337 Issued in FL
Practice address
701 W Plymouth Ave
Deland, FL 32720-3236
Phone
(386) 943-3160
Fax
(386) 943-3169
NPI assigned
May 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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 ME109337 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

701 W Plymouth Ave
Deland, FL 32720-3236

Mailing address

701 West Plymouth Avenue
Deland, FL 32720
Phone (386) 943-3160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110715000643 FL Practitioner - Internal Medicine 1850569997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-4522

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Flagler Inc CurrentSince Oct 1, 2018 Accepting new patients
Florida Hospital Healthcare Partners, Inc Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Southwest Volusia Healthcare Corporation Internal Medicine Past Accepting new patients

Locations

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: rmannaamannah59047@adventhealth.direct-ci.com

Organizations & group practices 3

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1255507117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WEST PLYMOUTH AVENUE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-943-3160",
            "fax_number": "386-943-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "386-943-3160",
            "fax_number": "386-943-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNAA MANNAH",
        "first_name": "RAAID",
        "middle_name": "HASSAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-01",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME109337",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.