Individual provider Active NPI

Ronal D Manis Jr., MD

  • Internal Medicine Physician
  • Piqua, OH
National Provider Identifier
1376557231
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.043967 Issued in OH
Practice address
1752 W High St
Piqua, OH 45356-9325
Phone
(937) 773-3737
Fax
(937) 440-4250
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 35-043967 OH
Internal Medicine Physician 207R00000X 35.043967 OH Primary

Addresses

Primary practice location

1752 W High St
Piqua, OH 45356-9325

Mailing address

3170 Kettering Blvd
BLDG B 3Rd FL
Moraine, OH 45439-1924
Phone (937) 991-3188

Other identifiers 1

IdentifierTypeStateIssuer
0583751MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110128000274 OH Practitioner - Internal MedicinePractitioner - Infectious Disease 6800075425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.89 of 100Reported as group
Quality
83.16
Promoting interoperability
100
Improvement activities
40
Cost
79.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.043967OHMDInternal Medicine Physician
35-043967OHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Valley Professional Corporation Internal Medicine CurrentSince Jul 29, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

1752 W High St
Piqua, OH 45356
Phone (513) 773-3737

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

Interoperability endpoints

  • Direct secure messaging: ronalmanis@ici.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1376557231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD",
            "address_2": "BLDG B 3RD FL",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188",
            "fax_number": "937-223-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 W HIGH ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453569325",
            "telephone_number": "937-773-3737",
            "fax_number": "937-440-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIS",
        "first_name": "RONAL",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35-043967",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.043967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0583751",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piqua, OH

Sources for this page

Verify at the official NPI Registry.