Raisa Alif Manejwala, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

06189 Issued in MD

Practice address

1819 Bay Ridge Ave Ste 190
Annapolis, MD 21403-2834

Phone

(443) 281-9430

Fax

(443) 782-2446

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bravo Psychological Group LLCGroup PAC ID 6800299496, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bravo Psychological Group, LLC

  • Clinical Psychologist
  • Gaithersburg, MD
  • NPI 1902475973

  DC

  Medicare reassignment Care Compare group NPD
• BPG Premiercare LLC

  • Mental Health Counselor
  • Gaithersburg, MD
  • NPI 1083480602
  NPD

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1316591985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BAY RIDGE AVE STE 190",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214032834",
            "telephone_number": "443-281-9430",
            "fax_number": "443-782-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BAY RIDGE AVE STE 190",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214032834",
            "telephone_number": "443-281-9430",
            "fax_number": "443-782-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEJWALA",
        "first_name": "RAISA",
        "middle_name": "ALIF",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva S. Malinowski, D.D.S.
• Kevin Michael Malone, M.D.
• Matthew J Malta, MD
• Nicole Kayla Manchego, FNP-C
• Alexandria Mancilla, LCSW-C
• William Mangana II, DNP
• Meredith Hady Mangels, MS, OTR/L
• Elizabeth Mangen, MAT, LAT, ATC
• Minerva Manilay, RNFA
• Eugene Thomas Manion, MD

• Psychologist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.