Individual provider Active NPI

Manu Madhok, MD

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1396857058
Registry record updated Apr 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
41503 Issued in MN
Practice address
2525 Chicago Avenue South
Childrens Hospitals and Clinics Emergency Physicians MP
Minneapolis, MN 55404
Phone
(612) 813-6111
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 41503 MN
Pediatrics Physician 208000000X 41503 MN Primary

Addresses

Primary practice location

2525 Chicago Avenue South
Childrens Hospitals and Clinics Emergency Physicians MP
Minneapolis, MN 55404

Mailing address

2910 Centre Pointe Drive 35 121a
Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2109

Other identifiers 1

IdentifierTypeStateIssuer
620727800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150513000033 MN Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 0042530131 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41503MNMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Pediatrics Current Accepting new patients
Childrens Health Care CurrentSince Feb 1, 2015 Accepting new patients
Childrens Health Care CurrentSince Feb 1, 2015 Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745020800000",
    "number": "1396857058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DRIVE 35 121A",
            "address_2": "CHILDRENS HEALTH CARE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2109",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVENUE SOUTH",
            "address_2": "CHILDRENS HOSPITALS AND CLINICS EMERGENCY PHYSICIANS MP",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADHOK",
        "first_name": "MANU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-04-19",
        "certification_date": "2025-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MN",
            "license": "41503",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "41503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620727800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.