NPIMap

Individual provider Active NPI

Manoharan Muthuvelu, MD MRCP FRCR MSC

  • Diagnostic Radiology Physician
  • Danville, PA
National Provider Identifier
1609062223
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD432405 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-0001
Phone
(570) 271-6301
Fax
(570) 271-5976
NPI assigned
Sep 18, 2007
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MD432405 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-0001

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
102092597MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmuthuvelu117383@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000162 PA Practitioner - Diagnostic Radiology 8820171572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians

Practice addresses (Care Compare)

1000 E Mountain Dr
Wilkes Barre, PA 18711-0001
Phone (570) 826-7850

529 High St
Lock Haven, PA 17745-3029
Phone (570) 748-8038

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD432405PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 1, 2014 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Sep 23, 2019 Accepting new patients
Geisinger-HM Joint Venture, LLC Diagnostic Radiology CurrentSince Sep 23, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 1, 2014 Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

529 High St
Lock Haven, PA 17745
Phone (570) 748-8034

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: mmuthuvelu117383@direct.geisinger.edu

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 58

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

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1609062223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001",
            "telephone_number": "570-271-6301",
            "fax_number": "570-271-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHUVELU",
        "first_name": "MANOHARAN",
        "name_prefix": "Dr.",
        "credential": "MD MRCP FRCR MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-18",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD432405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102092597",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmuthuvelu117383@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178220001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.