Individual provider Active NPI

Manuela Richie Tchate Sizyandji

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1427752971
Registry record updated Jul 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11023244A Issued in IN
Practice address
2231 Carew St
Fort Wayne, IN 46805-4713
Phone
(260) 373-7765
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11023244A IN Primary

Addresses

Primary practice location

2231 Carew St
Fort Wayne, IN 46805-4713

Mailing address

15918 Millwood Dr
Noblesville, IN 46060-4885
Phone (617) 959-3597

Other practice location 1

15918 Millwood Dr
Noblesville, IN 46060-4885
Phone (617) 959-3597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230629003097 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0547629172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11023244AINMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mtchatesizyandji566066@direct.parkviewexchange.com

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1427752971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15918 MILLWOOD DR",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604885",
            "telephone_number": "617-959-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054713",
            "telephone_number": "260-373-7765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15918 Millwood Dr",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460604885",
            "country_code": "US",
            "telephone_number": "617-959-3597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TCHATE SIZYANDJI",
        "first_name": "MANUELA RICHIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11023244A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.