Active NPI
Amit Koushik Manjunath, MD
- Orthopaedic Surgery Physician
- Philadelphia, PA
National Provider Identifier
1407436652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD492710
- Practice address
- 833 Chestnut St Ste 1220
Philadelphia, PA 19107-4413 - Phone
- (800) 321-9999
- NPI assigned
- Apr 12, 2021
- Sex
- Male
- Sole proprietor
- No
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
833 Chestnut St
Philadelphia, PA 19107-4499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260616001444 | NJ | Practitioner - Orthopedic Surgery | 0749752202 | |
| I20260616001821 | PA | Practitioner - Orthopedic Surgery | 0749752202 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- amanjunath204282@nyumc.direct-ci.com
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 25MA12935600 | NJ | |
| Orthopaedic Surgery Physician | 207X00000X | MD492710 | PA | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
833 Chestnut St Ste 1220
Philadelphia, PA 19107-4413
Mailing address
833 Chestnut St Ste 520
Philadelphia, PA 19107-4430
Phone (800) 321-9999
Other practice location 1
999 Route 73 N Ste 401
Marlton, NJ 08053-1227
Phone (800) 321-9999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2026.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1407436652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 CHESTNUT ST STE 520",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074430",
"telephone_number": "800-321-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 CHESTNUT ST STE 1220",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074413",
"telephone_number": "800-321-9999"
}
],
"practiceLocations": [
{
"address_1": "999 Route 73 N Ste 401",
"address_purpose": "LOCATION",
"city": "Marlton",
"state": "NJ",
"postal_code": "080531227",
"country_code": "US",
"telephone_number": "800-321-9999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANJUNATH",
"first_name": "AMIT",
"middle_name": "KOUSHIK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-12",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NJ",
"license": "25MA12935600",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "PA",
"license": "MD492710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.