NPIMap

Individual provider Active NPI

Madhavi Manyam, D.O

  • Gynecologic Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1255751970
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
2021036903 Issued in MO
Practice address
607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone
(314) 251-4260
NPI assigned
Apr 21, 2014
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2021036903 MO
Gynecologic Oncology Physician 207VX0201X 2021036903 MO Primary

Addresses

Primary practice location

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219

Mailing address

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone (314) 251-4260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920000984 MO Practitioner - Obstetrics/Gynecology 5698095800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic GYN Oncology LLCGroup PAC ID 6002917341, 5 clinicians

Practice addresses (Care Compare)

10050 Kennerly Rd
Suite 2500
Saint Louis, MO 63128-2106
Phone (314) 251-4260

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021036903MOMDObstetrics & Gynecology Physician
5334TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health Obstetrics & Gynecology CurrentSince Sep 18, 2023 Accepting new patients
Mercy Clinic GYN Oncology, LLC Gynecologic Oncology CurrentSince Sep 9, 2021 Accepting new patients
Erlanger Health CurrentSince Sep 18, 2023 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 25, 2025 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 25, 2025 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

10050 Kennerly Rd
Ste 2500
Saint Louis, MO 63128
Phone (314) 251-4260

607 S New Ballas Rd
Ste 2350
Saint Louis, MO 63141
Phone (314) 251-1340

607 S New Ballas Rd
Ste 3100
Saint Louis, MO 63141
Phone (314) 251-4260

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

102 Central Ave
Chattanooga, TN 37403
Phone (423) 266-3636

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Interoperability endpoints

  • Direct secure messaging: mmanyam1186850@directc.mercy.net
  • Direct secure messaging: mmanyam345958@direct.stlukeshealth.org
  • Direct secure messaging: mmanyam434097@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1255751970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYAM",
        "first_name": "MADHAVI",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2021036903",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MO",
            "license": "2021036903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.