Individual provider Active NPI

Manjula Nayyar, M.D.

  • Internal Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1467405506
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME39359 Issued in FL
Practice address
2580 Rhode Island Ave
Fort Pierce, FL 34947-4777
Phone
(772) 878-6568
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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 ME39359 FL Primary

Addresses

Primary practice location

2580 Rhode Island Ave
Fort Pierce, FL 34947-4777

Mailing address

2580 Rhode Island Ave
Fort Pierce, FL 34947-4777
Phone (772) 878-6568

Other identifiers 1

IdentifierTypeStateIssuer
066226700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040512000457 FL Practitioner - Internal Medicine 5496744518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pulmonary Medical Associates PAGroup PAC ID 4082603105, 2 clinicians

Practice addresses (Care Compare)

1576 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5450

1655 SE Walton Rd
Port Saint Lucie, FL 34952-7657
Phone (772) 337-1333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Medical Associates PA Internal Medicine CurrentSince Dec 1, 2003 Accepting new patients
Floridamedcare Internal Medicine Past Accepting new patients

Locations

2580 Rhode Island Ave
Ste C107
Fort Pierce, FL 34947
Phone (772) 461-4834

2580 Rhode Island Ave
Fort Pierce, FL 34947
Phone (772) 342-6911

1576 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 337-4578

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1467405506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 RHODE ISLAND AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474777",
            "telephone_number": "772-878-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 RHODE ISLAND AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474777",
            "telephone_number": "772-878-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAYYAR",
        "first_name": "MANJULA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME39359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066226700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.