Active NPI
Juan Carlos Manivel, M.D.
- Anatomic Pathology Physician
- Minneapolis, MN
National Provider Identifier
1609951771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 29459
- Practice address
- 420 Delaware St SE
760 Mayo BLDG
Minneapolis, MN 55455-0341 - Phone
- (612) 626-0622
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 29459 | MN | Primary |
Addresses
Primary practice location
420 Delaware St SE
760 Mayo BLDG
Minneapolis, MN 55455-0341
Mailing address
420 Delaware St SE
MMC 609
Minneapolis, MN 55455-0341
Phone (612) 626-0622
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0039975 | Medicaid | MT | |
| 0515908 | Medicaid | IA | |
| 1122550 | Other | MN | MEDICA CHOICE NUMBER |
| 2T224MA | Other | MN | BCBS MN NUMBER |
| HP22293 | Other | MN | HEALTHPARTNERS NUMBER |
| 1174545 | Other | MN | MEDICA DUAL SOLUTIONS NO. |
| 101364 | Other | MN | UCARE NO. |
| 32455000 | Medicaid | WI | |
| 719205300 | Medicaid | MN | |
| 1009228 | Other | MN | PREFERRED ONE NUMBER |
| 768244 | Other | MN | AMERICA'S PPO NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609951771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE",
"address_2": "MMC 609",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550341",
"telephone_number": "612-626-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE",
"address_2": "760 MAYO BLDG",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550341",
"telephone_number": "612-626-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANIVEL",
"first_name": "JUAN",
"middle_name": "CARLOS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "MN",
"license": "29459",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0039975",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0515908",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE NUMBER",
"identifier": "1122550",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN NUMBER",
"identifier": "2T224MA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS NUMBER",
"identifier": "HP22293",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA DUAL SOLUTIONS NO.",
"identifier": "1174545",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE NO.",
"identifier": "101364",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32455000",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "719205300",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE NUMBER",
"identifier": "1009228",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO NUMBER",
"identifier": "768244",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.