Active NPI
Nimmi Varghese Manaloor, M.B.B.S.
- Pediatrics Physician
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- U0157
- Practice address
- 19238 Stonehue
San Antonio, TX 78258-3447 - Phone
- (210) 494-2223
- Fax
- (210) 941-0142
- NPI assigned
- Apr 7, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11014722A | IN | |
| Pediatrics Physician | 208000000X | U0157 | TX | Primary |
Addresses
Primary practice location
19238 Stonehue
San Antonio, TX 78258-3447
Mailing address
6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201186330 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11014722A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Pediatrics | Current | Accepting new patients |
| Topcare Medical Group Inc | Past | Accepting new patients | |
| Abcd Pediatrics | Pediatrics | Past | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
13121 Olio Rd
Ste 340
Fishers, IN 46037
Phone (317) 621-1340
13121 Olio Rd
Ste 260
Fishers, IN 46037
Phone (317) 621-1300
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
Interoperability endpoints
- nmanaloor170968@ecommunitydirect.com
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
Pediatrics
-
- Endocrinology, Diabetes & Metabolism Physician
- Carmel, IN
- NPI 1992396337
-
- Pediatrics Physician
- San Antonio, TX
- NPI 1841280278
-
- Specialist
- Dallas, TX
- NPI 1730337163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1700029741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST",
"address_2": "SUITE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19238 STONEHUE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782583447",
"telephone_number": "210-494-2223",
"fax_number": "210-941-0142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANALOOR",
"first_name": "NIMMI",
"middle_name": "VARGHESE",
"credential": "M.B.B.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-07",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "11014722A",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "U0157",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201186330",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.