Manisha Rayavarapu, D.O.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

OS11541 Issued in FL

Practice address

305 W Central Ave
Lake Wales, FL 33853-4015

Phone

(866) 234-8534

NPI assigned

May 19, 2008

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Frostproof, FL
  • NPI 1467449660
  Medicare reassignment NPD
• Central Florida Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Lakeland, FL
  • NPI 1033605613
  NPD
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Bartow, FL
  • NPI 1811796469
  NPD
• Suncoast Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Dover, FL
  • NPI 1144230640
  NPD (past)

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1477710366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "863-229-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W CENTRAL AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534015",
            "telephone_number": "866-234-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYAVARAPU",
        "first_name": "MANISHA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS11541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radiology & Imaging Specialists of Lakeland
• Radiology Consultants, PA
• Rai Care Centers of Florida II, LLC
• Anu Chetticheril Raju
• Maurice Anthony Ramirez, D.O. PH.D.
• Real Asset Solutions Technologies & Investments LLC
• Jackson Steven Reddick, DMD
• Jacqueline Reddick
• Steven Douglas Reddick, D.M.D.
• Brenda Gail Register, RN

• Adult Medicine Physician in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.