Prerana Anand Manohar, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301080691 Issued in MI

Practice address

5043 Cascade Rd SE
Grand Rapids, MI 49546-3724

Phone

(616) 719-5939

Fax

(616) 719-5933

NPI assigned

Nov 3, 2005

Last updated

Mar 5, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Advantage Health/Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group Orthopedics Grand Rapids

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• West Michigan Heart

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
  • NPI 1174504021
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1265423651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5043 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463724",
            "telephone_number": "616-719-5939",
            "fax_number": "616-719-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5043 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463724",
            "telephone_number": "616-719-5939",
            "fax_number": "616-719-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOHAR",
        "first_name": "PRERANA",
        "middle_name": "ANAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301080691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4713480",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Paul Manning, PHARM D
• Stacey Katherine Manning, OTR
• Thomas A Manning, M.D.
• Emily Kaitlyn Mannion, PA
• Debra Maria Mannor, LLMSW
• Vinayak A Manohar, MD
• Brenda Manoharan, M.D.
• Rochelle G Manor, PH.D.
• Shaminy Anne Manoranjithan, MD
• Kurtrice Sharlynn Mansaray, CHW

• Cardiovascular Disease Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.