Individual provider Active NPI

Manjusha Rentala, MD

  • Emergency Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1629089719
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD062516L Issued in PA
Practice address
25 Church St
Wilkes Barre, PA 18702-3507
Phone
(570) 808-3100
Fax
(570) 808-2539
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD062516L PA Primary

Addresses

Primary practice location

25 Church St
Wilkes Barre, PA 18702-3507

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 808-3100

Other identifiers 1

IdentifierTypeStateIssuer
00G851680MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, MN, PA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20100605000100 NY Practitioner - Emergency Medicine 4385625516 Reassigns benefits to 5 organizations
I20190821000004 NJ Practitioner - Emergency Medicine 4385625516 Reassigns benefits to 8 organizations
I20231010000675 MN Practitioner - Emergency Medicine 4385625516 Reassigns benefits to 1 organization
I20250826002943 PA Practitioner - Emergency Medicine 4385625516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers New Jersey Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of South Jersey P CGroup PAC ID 5294648457, 94 clinicians
Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 Townsend Ave
Berlin, NJ 08009-9011
Phone (856) 322-3260

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5000

25 Church St
Wilkes Barre, PA 18765-0001
Phone (570) 826-3293

Hospital & facility affiliations

  • Saint Michael'S Medical Center Hospital, Newark, NJ, CCN 310096
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Oct 21, 2014 Accepting new patients
Geisinger Clinic CurrentSince Aug 18, 2025 Accepting new patients
Geisinger Clinic CurrentSince Aug 18, 2025 Accepting new patients
Nes Georgia Inc Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Ihpnj ER LLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Oct 21, 2014 Accepting new patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince May 1, 2020 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jun 3, 2023 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Jun 1, 2015 Accepting new patients
Geisinger Clinic Current Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jul 7, 2019 Accepting new patients
Prohealth Urgent Care Medicine of New Jersey LLP CurrentSince Dec 1, 2020 Accepting new patients
Interfaith Emergency Medicine, P.C. Emergency Medicine CurrentSince Jun 3, 2023 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Jun 3, 2023 Accepting new patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients
Atlanticare Physician Group CurrentSince Jul 7, 2019 Accepting new patients
Kingsbrook Medical Associates, PC Current Accepting new patients
Atlanticare Urgent Care Physicians LLC CurrentSince Jul 7, 2019 Accepting new patients
Garden State Healthcare Associates, LLC Emergency Medicine CurrentSince May 1, 2020 Accepting new patients
Kingsbrook Medical Associates PC Emergency Medicine CurrentSince Jun 3, 2023 Accepting new patients
CCM Health Current Accepting new patients
Atlanticare Physician Group PA Current Accepting new patients
Nes Georgia Inc Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
United Hospital District Inc. PastSince Oct 31, 2021 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients

Locations

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

1310 Blackwood Clementon Rd
Laurel Spgs, NJ 08021
Phone (609) 677-7200

415 W Saint Georges Ave
Linden, NJ 07036
Phone (908) 925-0363

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

1 Harmon Plz
Ste 1010
Secaucus, NJ 07094

255 N Route 73
West Berlin, NJ 08091
Phone (609) 569-7040

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

2960 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-2014

100 N Academy Ave
Danville, PA 17822

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

25 Church St
Wilkes Barre, PA 18765
Phone (570) 826-3100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: mrentala195517@direct-guthrie.org

Organizations & group practices 27

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.

View all 27

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1629089719",
    "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": "570-808-3100",
            "fax_number": "570-808-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023507",
            "telephone_number": "570-808-3100",
            "fax_number": "570-808-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTALA",
        "first_name": "MANJUSHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD062516L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G851680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.