Mredula Mannan

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

253733 Issued in MA

Practice address

85 Herrick St
Beverly, MA 01915-1790

Phone

(413) 543-6820

NPI assigned

Apr 17, 2009

Last updated

Oct 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA2 enrollments

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 2

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beth Israel Lahey Health Primary Care, IncGroup PAC ID 7719291434, 351 clinicians

Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Care Dimensions, Inc Hospice, Danvers, MA, CCN 221522
• Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

Merit-based Incentive Payment System (MIPS)

Final score

91.98 of 100Reported as apm

Quality

76.59

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
• Direct secure messaging: mmannan28944@direct.bilh.masshiway.net

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.

• Beth Israel Lahey Health Primary Care Inc

  dba Lahey Health Urgent Care, Middleboro

  • Clinic/Center
  • Middleboro, MA
  • NPI 1568292423
  Medicare reassignment Care Compare group NPD
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  dba Lahey Clinic

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment NPD
• Beth Israel Lahey Health Primary Care, Inc.

  • Internal Medicine Physician
  • Beverly, MA
  • NPI 1508244195
  NPD
• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Care Dimensions, Inc.

  • Community Based Hospice Care Agency
  • Danvers, MA
  • NPI 1447344130
  Care Compare affiliation Name & address match
• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation
• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  Care Compare affiliation
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  Care Compare affiliation

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1427291665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "413-543-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNAN",
        "first_name": "MREDULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "253733",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "253733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten Amanda Malsnee, M.D.
• Anna Alexandra Malyak, NP
• Natasa Mandic-Kuljic, DMD
• Marc Damian Manganiello, M.D.
• Sima Manifar, PHARMD
• Gabriella Manni
• Ryan Mansfield
• Cheyenne Manson
• Ann Elaine Manzi, MS RD LDN
• Alexandra Rose Maranto, LMHC

• Hospitalist Physician in Beverly, MA
• Providers in Beverly, MA by specialty
• Hospitalist Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.

Verify at the official NPI Registry.