Individual provider Active NPI

Manogna Pendyala, MD

  • Internal Medicine Physician
  • Newark, DE
National Provider Identifier
1699466011
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0106871 Issued in MD
Practice address
4755 Ogletown Stanton Rd Ste 5A43
Newark, DE 19718-2200
Phone
(302) 623-0188
Fax
(302) 733-5640
NPI assigned
May 17, 2023
Last updated
Jun 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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 C1-0029502 DE
Internal Medicine Physician 207R00000X D0106871 MD Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Ste 5A43
Newark, DE 19718-2200

Mailing address

4755 Ogletown Stanton Rd Ste 5A43
Newark, DE 19718-2200
Phone (302) 623-0188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20260625004367 DE Practitioner - Internal Medicine 7517490899

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 623-0188

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1699466011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 5A43",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-623-0188",
            "fax_number": "302-733-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 5A43",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-623-0188",
            "fax_number": "302-733-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDYALA",
        "first_name": "MANOGNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0029502",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0106871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.