Individual provider Active NPI

Eleni K. Maneta, M.D.

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1639369705
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
232621 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 326-3177
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD466474 PA
Psychiatry Physician 2084P0800X 232621 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

100 New Salem Rd
Ste 116
Uniontown, PA 15401-8936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190828003365 PA Practitioner - Psychiatry 6507900982 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232621MAMDPsychiatry Physician
MD466474PAMDChild & Adolescent Psychiatry Physician
241904MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Ridge Counseling Services Inc Psychiatry CurrentSince Aug 1, 2019 Accepting new patients
Mount Auburn Hospital Past Accepting new patients

Locations

1051 Morrell Ave
Connellsville, PA 15425
Phone (724) 427-0729

100 New Salem Rd
Ste 116
Uniontown, PA 15401

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1639369705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NEW SALEM RD",
            "address_2": "STE 116",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-326-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANETA",
        "first_name": "ELENI",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD466474",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "232621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.