Individual provider Active NPI

Manish Kumar, M.D.

  • Pediatrics Physician
  • Vestal, NY
National Provider Identifier
1669679221
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
285259 Issued in NY
Practice address
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone
(607) 797-1251
Fax
(607) 729-4393
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 285259 NY Primary

Addresses

Primary practice location

4417 Vestal Pkwy E
Vestal, NY 13850-3556

Mailing address

33 Lewis Rd
2ND FL
Binghamton, NY 13905
Phone (607) 729-8156

Other identifiers 1

IdentifierTypeStateIssuer
1024806310001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100914001029 PA Practitioner - Pediatric Medicine 0749305738 Reassigns benefits to 2 organizations
I20180126000825 NY Practitioner - Pediatric Medicine 0749305738 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285259NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital Current Accepting new patients
Reading Hospital CurrentSince Jul 1, 2010 Accepting new patients
Reading Hospital CurrentSince Jul 1, 2010 Accepting new patients
Tower Health Medical Group CurrentSince Aug 29, 2010 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Aug 29, 2010 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Nov 20, 2017 Accepting new patients
United Health Services Hospitals, Inc. Past Accepting new patients
United Medical Associates PC Past Accepting new patients

Locations

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33 Lewis Rd
Ste 2
Binghamton, NY 13905

4417 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 729-2144

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • FHIR API: https://epicproxy.et1127.epichosted.com/FHIRproxy/api/FHIR/R4/

Organizations & group practices 9

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669679221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-729-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-797-1251",
            "fax_number": "607-729-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "MANISH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "285259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024806310001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.