Manus Praserthdam,M.D.,P.a

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MANUS PRASERTHDAM,M.D.,P.A

Practice address

1201 5TH Ave N Ste 208
St Petersburg, FL 33705-1410

Phone

(727) 894-1122

Fax

(727) 894-0033

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Manus Praserthdam, M.D.NPI 1891787917

Title

Owner

Phone

(727) 894-1122

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manus Praserthdam, M.D.

  • Specialist
  • St Petersburg, FL
  • NPI 1891787917
  NPD (past) Authorized official

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1376770826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N STE 208",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051410",
            "telephone_number": "727-894-1122",
            "fax_number": "727-894-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N STE 208",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051410",
            "telephone_number": "727-894-1122",
            "fax_number": "727-894-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUS PRASERTHDAM,M.D.,P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "PRASERTHDAM",
        "authorized_official_first_name": "MANUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-894-1122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0666950",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62149",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0184828",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "212769",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3106012",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Mannari, D.M.D., M.S.
• Michael H Manning Jr., MD
• Ahmed Mansour
• Ana Cristina Mantilla, DPM
• Gigi Michelle Manuel, ARNP/FNP
• Christine Ann Manzella, O.D., M.P.H.
• Jason Michael Manzella, D.O.
• Seymour Manzon, M.D.
• Michael Mappes
• Christine Mara, PT, DPT, ATC

• Specialist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.