Divya Manohara

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A176136 Issued in CA

Practice address

1035 Peach St Ste 301
San Luis Obispo, CA 93401-2700

Phone

(805) 369-8860

NPI assigned

Apr 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: divya.manohara.p8@direct.bfmc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Coastal Communities Physician Network, Inc.

  • Health Maintenance Organization
  • San Luis Obispo, CA
  • NPI 1275735011
  Medicare reassignment NPD
• Bakersfield Family Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Bakersfield, CA
  • NPI 1013912641

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1477086122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST STE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-369-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST STE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-369-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOHARA",
        "first_name": "DIVYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A176136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauryn Alexis Mankarios
• Enn Mannard, M.D.
• Catherine Manning
• Chris W Manning III, DDS
• Shawnya Marie Manning, LPT
• Disbel Rebeca Mansilla, D.D.S.
• Sarfaraz A Mansuri, MD
• Ethan James Manville
• Leonard Stephan Manzella, LCSW
• Alyssa Carmina Maragliotti

• Internal Medicine Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.