Individual provider Active NPI

Roselyn Abalos Manus, M.D.

  • Internal Medicine Physician
  • Fairlawn, OH
National Provider Identifier
1689665127
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35078493 Issued in OH
Practice address
822 Kumho Dr
Suite 202
Fairlawn, OH 44333-9297
Phone
(330) 576-0500
Fax
(330) 576-0467
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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 35078493 OH Primary
Hospitalist Physician 208M00000X 35-078493 OH

Addresses

Primary practice location

822 Kumho Dr
Suite 202
Fairlawn, OH 44333-9297

Mailing address

3546 Chanticleer CT
Uniontown, OH 44685-8190
Phone (330) 320-0145

Other identifiers 9

IdentifierTypeStateIssuer
341960347OtherOHSUMMA
23955OtherOHQUALCHOICE
2191640MedicaidOH
341960347DOtherOHAULTCARE
7120189OtherOHAETNA
11682367300OtherOHBWC
05200OtherOHKAISER PERMANENTE
5628939OtherOHFIRST HEALTH NETWORK
000000342548OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20150325000978 DC Practitioner - Internal Medicine 1759365117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-078493OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC Internal Medicine CurrentSince May 1, 2021 Accepting new patients
WHC Physician Group LLC CurrentSince Dec 28, 2014 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2021 Accepting new patients
WHC Emerg Phys CurrentSince Dec 28, 2014 Accepting new patients
Summa Physicians LLC Past Accepting new patients
Premier Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1689665127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 CHANTICLEER CT",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446858190",
            "telephone_number": "330-320-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 KUMHO DR",
            "address_2": "SUITE 202",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339297",
            "telephone_number": "330-576-0500",
            "fax_number": "330-576-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUS",
        "first_name": "ROSELYN",
        "middle_name": "ABALOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35078493",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35-078493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMA",
            "identifier": "341960347",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "23955",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2191640",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AULTCARE",
            "identifier": "341960347D",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7120189",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "11682367300",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "05200",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "5628939",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000342548",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.