NPIMap

Individual provider Active NPI

Manish Dimri, MD

  • Internal Medicine Physician
  • Odessa, TX
National Provider Identifier
1609823111
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M5134 Issued in TX
Practice address
701 W 5TH St
Odessa, TX 79763-4206
Phone
(432) 335-1777
Fax
(432) 335-1815
NPI assigned
May 28, 2006
Last updated
Jul 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M5134 TX Primary

Addresses

Primary practice location

701 W 5TH St
Odessa, TX 79763-4206

Mailing address

1816 N Midland Dr
Midland, TX 79707-6407
Phone (432) 699-5111

Other identifiers 2

IdentifierTypeStateIssuer
4067199OtherTNBLUE SHIELD OF TENNESSEE
3864119MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070508000173 TX Practitioner - Internal Medicine 5597790683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5293 PO Box
Midland, TX 79704

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.33 of 100Reported as individual
Quality
95.3
Improvement activities
40
Cost
70.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35060TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manish Dimri MD PA Internal Medicine CurrentSince Feb 19, 2012 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Midland Orthopedic Specialists Group Past Accepting new patients
Basin Cardiothoracic & Vascular Surgery Associates Past Accepting new patients
Premier Family Care I, Inc Internal Medicine Past Accepting new patients
Emergency Coverage, LLC Internal Medicine Past Accepting new patients
Abulbasher M Faizullah MD PA Internal Medicine PastSince Feb 19, 2012 Accepting new patients

Locations

1816 N Midland Dr
Midland, TX 79707
Phone (432) 699-5111

3407 Caldera Blvd
Midland, TX 79707
Phone (432) 688-0031

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7097/brand/1/csg/1/fhir/r4
  • Direct secure messaging: manish.dimri.1@7097.direct.athenahealth.com
  • Direct secure messaging: manish.dimri.4@7097.direct.athenahealth.com

Organizations & group practices 7

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 3

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1609823111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 N MIDLAND DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797076407",
            "telephone_number": "432-699-5111",
            "fax_number": "432-699-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-335-1777",
            "fax_number": "432-335-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMRI",
        "first_name": "MANISH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M5134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF TENNESSEE",
            "identifier": "4067199",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3864119",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.