Manish Kanukunta, MD

Key facts

NPI

1629655113

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

25329 (NV)

Practice address

10624 S Eastern Ave # a-955
Henderson, NV 89052-2982

Phone

(702) 800-5393

Fax

(702) 407-7016

NPI assigned

Mar 29, 2021

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Platinum Hospitalists LLP Hospitalist Physician · Henderson, NV · NPI 1861627242
  Medicare reassignment Care Compare group NPD INTERNAL MEDICINE · NV
• Platinum Hospitalists LLP Internal Medicine Physician · Henderson, NV · NPI 1437948726
  NPD INTERNAL MEDICINE
• Centennial Hills Hospital Medical Center General Acute Care Hospital · Las Vegas, NV · NPI 1487771812
  NPD (past)
• Henderson Hospital General Acute Care Hospital · Henderson, NV · NPI 1003281452
  NPD (past)
• West Henderson Hospital Medical Center LLC General Acute Care Hospital · Henderson, NV · NPI 1962181172
  NPD (past)

Hospital & facility affiliations 5

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

• Dignity Health General Acute Care Hospital · Henderson, NV · NPI 1770626426
  Care Compare affiliation Hospital
• Henderson Hospital General Acute Care Hospital · Henderson, NV · NPI 1003281452
  Care Compare affiliation Hospital
• Henderson Hospital Emergency Care Clinic/Center · Henderson, NV · NPI 1285490292
  Care Compare affiliation Hospital
• Henderson Hospital Emergency Care Clinic/Center · Henderson, NV · NPI 1376198028
  Care Compare affiliation Hospital
• West Henderson Hospital Medical Center LLC General Acute Care Hospital · Henderson, NV · NPI 1962181172
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Internal Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Platinum Hospitalists LLP (197 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Henderson Hospital Hospital · Henderson, NV · CCN 290062
• Henderson Hospital Hospital · Henderson, NV · CCN 290057
• Saint Rose Dominican Hospitals - Siena Campus Hospital · Henderson, NV · CCN 290045

Merit-based Incentive Payment System (MIPS)

Final score

61.15 of 100 (group)

Quality

36.67

Improvement activities

40

Cost

61.8

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: manish.kanukunta@hca3.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 24, 2024.

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1629655113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-800-5393",
            "fax_number": "702-407-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-800-5393",
            "fax_number": "702-407-7016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280436",
            "country_code": "US",
            "telephone_number": "702-962-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANUKUNTA",
        "first_name": "MANISH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "25329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629655113",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Henderson, NV · Internal Medicine Physician in Nevada