Individual provider Active NPI

Manolisa Tandoc Cornel-Manaloto, M.D.

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1679533327
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101232671 Issued in VA
Practice address
12710 Darby Brook CT
Woodbridge, VA 22192-2486
Phone
(703) 499-9655
Fax
(703) 499-9535
NPI assigned
Mar 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101232671 VA Primary

Addresses

Primary practice location

12710 Darby Brook CT
Woodbridge, VA 22192-2486

Mailing address

12710 Darby Brook CT
Woodbridge, VA 22192-2486
Phone (703) 499-9655

Other names 1

  • Dr. Manolisa Tandoc Cornel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20050119000106 VA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4385693209 Reassigns benefits to 1 organization
I20220714000293 DC Practitioner - Internal Medicine 4385693209 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Cardiovascular Associates, P.C. CurrentSince Oct 1, 2017 Accepting new patients
Rapha Medical Group, LLC Internal Medicine CurrentSince May 1, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

8638 Centreville Rd
Manassas, VA 20110
Phone (703) 361-2930

12710 Darby Brook Ct
Woodbridge, VA 22192
Phone (703) 496-4190

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24525/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/11138/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1679533327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12710 DARBY BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922486",
            "telephone_number": "703-499-9655",
            "fax_number": "703-499-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 DARBY BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922486",
            "telephone_number": "703-499-9655",
            "fax_number": "703-499-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEL-MANALOTO",
        "first_name": "MANOLISA",
        "middle_name": "TANDOC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-26",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101232671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANOLISA",
            "last_name": "CORNEL",
            "middle_name": "TANDOC",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.