NPIMap

Individual provider Active NPI

Vinayak A Manohar, MD

  • Interventional Cardiology Physician
  • Grand Rapids, MI
National Provider Identifier
1306855242
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
4301092435 Issued in MI
Practice address
1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383
Phone
(616) 685-3450
Fax
(616) 685-8322
NPI assigned
Aug 7, 2006
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48691 MN
Cardiovascular Disease Physician 207RC0000X 4301092435 MI
Interventional Cardiology Physician 207RI0011X 4301092435 MI Primary

Addresses

Primary practice location

1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383

Mailing address

1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383
Phone (616) 685-3450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120910000435 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Surgery 5890799746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Jefferson Medical College of Thomas Jefferson University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 E Paris Ave SE
Suite 200
Grand Rapids, MI 49546-8383
Phone (616) 685-3450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48691MNMDInternal Medicine Physician
4301092435MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 10, 2017 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Metropolitan Hospital Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 10, 2017 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1000 East Paris Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 685-3450

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Organizations & group practices 4

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 5

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1306855242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468383",
            "telephone_number": "616-685-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468383",
            "telephone_number": "616-685-3450",
            "fax_number": "616-685-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOHAR",
        "first_name": "VINAYAK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "48691",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301092435",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301092435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.