NPIMap

Individual provider Active NPI

Tamunoinemi Disrael Bob-Manuel, M.D

  • Interventional Cardiology Physician
  • Germantown, TN
National Provider Identifier
1366838856
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
64950 Issued in TN
Practice address
8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone
(901) 271-1000
Fax
(901) 271-4187
NPI assigned
Apr 10, 2015
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 64950 TN Primary

Addresses

Primary practice location

8060 Wolf River Blvd
Germantown, TN 38138-1727

Mailing address

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Other identifiers 2

IdentifierTypeStateIssuer
64950OtherTNTN LICENSE
Q073784MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220318001569 TN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2264743434 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians
Stern Cardiovascular Foundation, IncGroup PAC ID 8123200540, 111 clinicians

Practice addresses (Care Compare)

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting31
Pacemaker insertion or repair1-10
Varicose vein removal79
Leg revascularization (restoring blood flow)35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64950TNMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Hospital CurrentSince Jan 1, 2026 Accepting new patients
Stern Cardiovascular Foundation, Inc CurrentSince Mar 1, 2022 Accepting new patients
Baptist Memorial Hospital CurrentSince Jan 1, 2026 Accepting new patients
Stern Cardiovascular Center, PA CurrentSince Nov 1, 2025 Accepting new patients

Locations

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

8060 Wolf River Blvd
Memphis, TN 38138
Phone (901) 271-2272

Interoperability endpoints

  • Direct secure messaging: tamunoinemibob-manuel@stern.allscriptsdirect.net

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 8

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1366838856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-1000",
            "fax_number": "901-271-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-1000",
            "fax_number": "901-271-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOB-MANUEL",
        "first_name": "TAMUNOINEMI",
        "middle_name": "DISRAEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "64950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "64950",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q073784",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.