Individual provider Active NPI

Diana K McManus, M.D.

  • Pediatrics Physician
  • Worcester, MA
National Provider Identifier
1699848903
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
230479 Issued in MA
Practice address
630 Plantation St
Worcester, MA 01605
Phone
(508) 852-8570
Fax
(508) 852-1022
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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 230479 MA Primary

Addresses

Primary practice location

630 Plantation St
Worcester, MA 01605

Mailing address

378 Maple Ave
Shrewsbury, MA 01545-2675
Phone (508) 852-8570

Other identifiers 1

IdentifierTypeStateIssuer
2128535MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20070123000311 MA Practitioner - Pediatric Medicine 0840291597 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Pediatrics CurrentSince Nov 17, 2010 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

378 Maple Ave
Shrewsbury, MA 01545
Phone (508) 595-2513

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

  • Direct secure messaging: diana.mcmanus.npi1699848903.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1699848903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 MAPLE AVE",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015452675",
            "telephone_number": "508-852-8570",
            "fax_number": "508-852-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-852-8570",
            "fax_number": "508-852-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "DIANA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "230479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2128535",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.