Lawrence B. Manalo, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

103919 Issued in GA

Practice address

1120 15TH St
Augusta, GA 30912-0004

Phone

(706) 721-2209

Fax

(706) 721-7319

NPI assigned

Apr 7, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, AL, LA, GA4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmanalo621131@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• University Hospital & Clinics, Inc.

  • Anesthesiology Physician
  • Lafayette, LA
  • NPI 1639518087
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• University of California SFGH Medical Group

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1063487122
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Surgery Physician
  • Douglasville, GA
  • NPI 1164715132
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• University Hospital & Clinics Inc

  • Community/Retail Pharmacy
  • Lafayette, LA
  • NPI 1740739044
  NPD
• University of California SFGH Medical Group

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1306281126
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902
  Care Compare affiliation

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

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1265798938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 TULANE AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122865",
            "telephone_number": "504-568-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-2209",
            "fax_number": "706-721-7319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1542 Tulane Ave",
            "address_2": "Department of Radiology",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122865",
            "country_code": "US",
            "telephone_number": "504-568-4647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANALO",
        "first_name": "LAWRENCE",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "103919",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD.206240",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2196448",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmanalo621131@directwellstar.org",
            "affiliation": "N",
            "address_1": "1120 15th St",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309120004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gary Michael Mallow
• Deja Malone
• William Harris Maloy, MD
• Mama'S Labor of Love LLC
• Annamma T. Mammen, MD
• Elizabeth J. Manaloor, MD
• Mahendra K. Mandawat, MD
• Brittany Maner, MD
• Donald Earl Maner Sr., PA-C
• Marien Mangrobang

• Diagnostic Radiology Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.