NPIMap

Individual provider Active NPI

Manish Kumar Mishra, M.D

  • Family Medicine Physician
  • Pottsville, PA
National Provider Identifier
1306089222
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD446292 Issued in PA
Practice address
700 Schuylkill Manor Rd
Suuite 5a
Pottsville, PA 17901-3849
Phone
(570) 516-9444
Fax
(570) 728-2360
NPI assigned
Apr 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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
Family Medicine Physician 207Q00000X MD446292 PA Primary

Addresses

Primary practice location

700 Schuylkill Manor Rd
Suuite 5a
Pottsville, PA 17901-3849

Mailing address

82 Tunnel Rd
Pottsville, PA 17901-3869
Phone (570) 622-5455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120830000596 PA Practitioner - Internal MedicinePractitioner - Family Practice 9335396068 Reassigns benefits to 2 organizations

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
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, 2,775 clinicians
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians
Img Nursing Home Care, P.C.Group PAC ID 8628491735, 11 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2222 Sullivan Trail
Easton, PA 18040-7958

2222 Sullivan TRL
Easton, PA 18040-7958
Phone 61043820201010

700 Schuylkill Manor Rd
Suite 5a
Pottsville, PA 17901-3849
Phone (570) 516-9444

82 Tunnel Rd
Pottsville, PA 17901-3869
Phone (570) 622-5455

Hospital & facility affiliations

  • Geisinger Home Health Home health agency, Hazle Township, PA, CCN 398030
  • Lehigh Valley Health Network Home health agency, Saint Clair, PA, CCN 397214
  • Advantage Home Health and Hospice Home health agency, Pottsville, PA, CCN 398225
  • Bayada Home Health Care, Inc. Home health agency, Wyomissing, PA, CCN 398035
  • Accentcare Home Health of Central Pennsylvania Home health agency, Elizabethtown, PA, CCN 398062
  • Compassus - Greater Philadelphia Hospice, Hamburg, PA, CCN 391649
  • Choices Healthcare Hospice, Lancaster, PA, CCN 391515
  • Hospice of Central Pennsylvania Hospice, Harrisburg, PA, CCN 391530
  • Lehigh Valley Hospice Hospice, Allentown, PA, CCN 391521
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183
  • Lehigh Valley Hospital-Schuylkill Inpatient rehabilitation facility, Pottsville, PA, CCN 39T030
  • Rosewood Rehabilitation and Nursing Center Nursing home, Schuylkill Haven, PA, CCN 395416
  • Gardens at York Terrace, the Nursing home, Pottsville, PA, CCN 395252
  • Schuylkill Center Nursing home, Pottsville, PA, CCN 395831
  • Seton Manor Nursing and Rehabilitation Center Nursing home, Orwigsburg, PA, CCN 396063
  • Green Valley Skilled Nursing and Rehabilitation Ce Nursing home, Pottsville, PA, CCN 396086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD446292PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Oct 11, 2016 Accepting new patients
Integrated Medical Group P C Family Medicine CurrentSince Oct 11, 2016 Accepting new patients
Img Nursing Home Care, P.C. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Schuylkill Center Opco LLC Past Accepting new patients
Pottsville Operations LLC Past Accepting new patients
Rest Haven Operating, LLC Past Accepting new patients
Integrated Medical Group Past Accepting new patients
The Meadows at Pottsville for Nursing and Rehabilitation LLC PastSince Aug 1, 2016 Accepting new patients
Lehigh Valley Hospital - Schuylkill Past Accepting new patients
SM Rehab & Nursing Center LLC Past Accepting new patients
Pottsville SNF Operations LLC Past Accepting new patients

Locations

700 Schuylkill Manor Rd
Ste 5A
Pottsville, PA 17901
Phone (570) 516-9444

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

401 University Dr
Schuylkill Haven, PA 17972
Phone (570) 385-0331

Interoperability endpoints

  • Direct secure messaging: mmishra@imgpc.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Gardens at York TerracePottsville, PA, CCN 395252 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2016
Aug 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1306089222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 TUNNEL RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013869",
            "telephone_number": "570-622-5455",
            "fax_number": "570-622-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCHUYLKILL MANOR RD",
            "address_2": "SUUITE 5A",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013849",
            "telephone_number": "570-516-9444",
            "fax_number": "570-728-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "MANISH",
        "middle_name": "KUMAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD446292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.