Philip Manger, MD
Individual provider Active NPI Otolaryngology Physician · Baxter, MN
NPI 1699709089 · NPPES record last updated May 21, 2022
Key facts
- NPI
- 1699709089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 47977 (MN)
- Practice address
- 13359 Isle Dr Ste 1
Baxter, MN 56425-2223 - Phone
- (218) 454-8888
- Fax
- (888) 835-7231
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- Boston University School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Specialty Associates
Practice addresses (Care Compare)
13359 Isle Dr
Suite 1
Baxter, MN 56425-2223
Phone (218) 454-8888
Hospital & facility affiliations
- Welia Health
- Essentia Health St Joseph'S Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050606000252 | MN | Practitioner - Otolaryngology | 6507809118 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47977 | MN | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Welia Health | Current |
Accepting new patients | |
| Advanced Specialty Associates, LTD | Current |
Accepting new patients | |
| Welia Health | Current |
Accepting new patients | |
| Astera Health | Current |
Accepting new patients | |
| Astera Health | Current |
Accepting new patients |
Locations
13114 Isle Dr
Baxter, MN 56425
Phone (218) 822-2400
13359 Isle Dr
Ste 1
Brainerd, MN 56425
Phone (218) 454-3077
301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317
991 Sibley Memorial Hwy
Ste 202
Saint Paul, MN 55118
Phone (651) 493-8501
415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510
4 Deerwood Ave NW
Wadena, MN 56482
Phone (218) 631-1100
Interoperability endpoints
- pmanger520086@direct.centracare.com
- pmanger@directaddress.net
- pmanger86392@excellian.direct.allina.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 47977 | MN | Yes |
Addresses
Primary practice location
13359 Isle Dr Ste 1
Baxter, MN 56425-2223
Mailing address
13359 Isle Dr Ste 1
Brainerd, MN 56425-2223
Phone (218) 454-3077
Other practice location 1
301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 679-1212
Other practice location 2
991 Sibley Memorial Hwy Ste 202
Saint Paul, MN 55118-5116
Phone (124) 645-2396
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 156657100 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pmanger86392@excellian.direct.allina.com | Direct | |
| Direct Messaging Address | pmanger@directaddress.net |
Other providers in Baxter, MN
- Nadia Maddaus
- James D Madison
- Tiffany Lynn Madson
- Tracey Marie Malone
- Nicole Therese Manecke
- Lindsay Martin
- Sheila Elizabeth Martin
- Lora C Martinson
- Kiersten Micael Boehm Masello
- Jerome Mauro
All providers in Baxter, MN · Otolaryngology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.