Individual provider Active NPI

Manasa Musunuri, M.D.

  • Psychiatry Physician
  • Angola, IN
National Provider Identifier
1487929816
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.124099 Issued in OH
Practice address
301 E Maumee St
Angola, IN 46703-2012
Phone
(260) 667-5635
Fax
(260) 665-8852
NPI assigned
Mar 19, 2012
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.124099 OH Primary
Child & Adolescent Psychiatry Physician 2084P0804X 45303 KY

Addresses

Primary practice location

301 E Maumee St
Angola, IN 46703-2012

Mailing address

301 E Maumee St
Angola, IN 46703-2012
Phone (260) 667-5635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NC, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141002002532 OH Practitioner - Psychiatry 7113147745 Reassigns benefits to 1 organization
I20211206002466 NC Practitioner - Psychiatry 7113147745 Reassigns benefits to 1 organization
I20230823000402 IN Practitioner - Psychiatry 7113147745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

301 E Maumee St
Angola, IN 46703-2012
Phone (260) 675-7535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.124099OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Nov 1, 2021 Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Jul 31, 2023 Accepting new patients
Cameron Memorial Community Hospital, Inc Psychiatry CurrentSince Jul 31, 2023 Accepting new patients
Monarch Current Accepting new patients
Monarch CurrentSince Nov 1, 2021 Accepting new patients
Unison Behavioral Health Group, Inc. CurrentSince Nov 1, 2017 Accepting new patients

Locations

301 E Maumee St
Angola, IN 46703
Phone (260) 665-2164

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

1425 Starr Ave
Toledo, OH 43605
Phone (419) 259-4506

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1487929816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032012",
            "telephone_number": "260-667-5635",
            "fax_number": "260-665-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032012",
            "telephone_number": "260-667-5635",
            "fax_number": "260-665-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSUNURI",
        "first_name": "MANASA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.124099",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "45303",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.