Individual provider Active NPI

Joanna Manghelli, D.O

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1265844849
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02004794A Issued in IN
Practice address
1701 N Senate Blvd
Ag012
Indianapolis, IN 46202-1239
Phone
(317) 962-5975
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11017652A IN
Emergency Medicine Physician 207P00000X 02004794A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Ag012
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Suite 130
Indianapolis, IN 46219-4959
Phone (317) 963-2514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160712000346 IN Practitioner - Emergency Medicine 4789809807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical AssociatesGroup PAC ID 0840184164, 40 clinicians

Practice addresses (Care Compare)

1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone (317) 355-5041

Hospital & facility affiliations

  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Howard Regional Health Inc. Hospital, Kokomo, IN, CCN 150007
  • Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
95.35
Improvement activities
40
Cost
78.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11017652AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc CurrentSince Jul 1, 2016 Accepting new patients
Medical Associates Emergency Medicine CurrentSince Dec 5, 2016 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

1701 Senate Blvd
#12
Indianapolis, IN 46202
Phone (317) 962-3525

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

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 4

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1265844849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-963-2514",
            "fax_number": "317-962-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "address_2": "AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGHELLI",
        "first_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11017652A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02004794A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.