Manoharan W Eustace, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME056842 Issued in MI

Practice address

1032 N Irish Rd
Davison, MI 48423-2209

Phone

(810) 658-2131

Fax

(810) 658-3500

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Internal Medicine

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Home Health Home health agency, Davison, MI, CCN 237010
• Hurley Medical Center Hospital, Flint, MI, CCN 230132
• Hurley Medical Center Inpatient rehabilitation facility, Flint, MI, CCN 23T132

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: meustace4358@direct.hurleymc.com
• Direct secure messaging: meustace1126397@direct.hfhs.org

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.

• M.W. Eustace M.D. PLC

  • Specialist
  • Davison, MI
  • NPI 1881725893
  Medicare reassignment Authorized official
• Adulteldercarepc

  • Primary Care Clinic/Center
  • Davison, MI
  • NPI 1568593093
  NPD
• Hurley Medical Center

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1598717480
  NPD (past)

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

• Hurley Medical Center

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1598717480
  Care Compare affiliation
• Hurley Medical Center

  • Rehabilitation Hospital Unit
  • Flint, MI
  • NPI 1851496210

  Inpatient rehabilitation facility

  Care Compare affiliation
• McLaren Health Management Group

  dba McLaren Home Health

  • Home Health Agency
  • Davison, MI
  • NPI 1023059144
  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1487614723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 N IRISH RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232209",
            "telephone_number": "810-658-2131",
            "fax_number": "810-658-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 N IRISH RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232209",
            "telephone_number": "810-658-2131",
            "fax_number": "810-658-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSTACE",
        "first_name": "MANOHARAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "ME056842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "3E22022",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "C3246",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS M",
            "identifier": "110250037",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4203754",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0250037",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Russell Eikey, PT
• Arwa El Rifai, M.D.
• Jonathan Elin-Calcador, OD
• Christopher Elliot, FNP-BC
• Marielle Elliot, FNP-BC
• Tara Rae Evans, NP-C
• David Lee Ewing, DDS
• Eyecare Associates
• Mary F Fairweather, RPH
• Family Fare, LLC (VG's Pharmacy #1930)

• Internal Medicine Physician in Davison, MI
• Providers in Davison, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.