Individual provider Active NPI

Manish Pandya, M.D.

  • Internal Medicine Physician
  • Bishop, CA
National Provider Identifier
1659719755
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A143586 Issued in CA
Practice address
150 Pioneer LN
Bishop, CA 93514-2556
Phone
(760) 873-5811
NPI assigned
Jun 11, 2013
Last updated
Sep 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301103240 MI
Internal Medicine Physician 207R00000X A143586 CA Primary

Addresses

Primary practice location

150 Pioneer LN
Bishop, CA 93514-2556

Mailing address

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170824002720 MI Practitioner - Internal Medicine 5890926133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143586CAMDInternal Medicine Physician
4301103240MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Sep 1, 2017 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

30000 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 470-2190

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

Organizations & group practices 3

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 4

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": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1659719755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556",
            "telephone_number": "760-873-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556",
            "telephone_number": "760-873-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "MANISH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301103240",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A143586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

Verify at the official NPI Registry.