Individual provider Active NPI

Richard Alexander Manfready, M.D.

  • Gastroenterology Physician
  • Waterloo, IA
National Provider Identifier
1710419122
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD-51934 Issued in IA
Practice address
1015 S Hackett Rd
Waterloo, IA 50701-3500
Phone
(319) 234-5990
Fax
(319) 234-5994
NPI assigned
Apr 3, 2017
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036.152697 IL
Gastroenterology Physician 207RG0100X MD-51934 IA Primary

Addresses

Primary practice location

1015 S Hackett Rd
Waterloo, IA 50701-3500

Mailing address

PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390

Other practice location 1

1725 W Harrison St Ste 207
Chicago, IL 60612-3988
Phone (312) 942-5861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230905003803 IA Practitioner - Gastroenterology 1254677578 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Tulane University School of Medicine, 2017
Medicare assignment
May accept Medicare assignment
Group practices
New Gi PCGroup PAC ID 2567930985, 22 clinicians

Practice addresses (Care Compare)

1015 S Hackett Rd
Waterloo, IA 50701-3500
Phone (319) 234-5990

1753 W Ridgeway Ave
Waterloo, IA 50701-4588

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3941

4150 Kimball Ave
Waterloo, IA 50701-9086

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy99
Upper gastrointestinal (GI) endoscopy for acid reflux161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.152697ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Memorial Hospital Corporation Current Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Cedar Valley Medical Specialists PC CurrentSince Oct 1, 2023 Accepting new patients
Cedar Valley Medical Specialists PC Gastroenterology CurrentSince Oct 1, 2023 Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Sep 1, 2024 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients

Locations

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

1015 S Hackett Rd
Waterloo, IA 50701
Phone (319) 234-5990

1015 S Hackett Rd
Ste B
Waterloo, IA 50701
Phone (319) 406-5990

Interoperability endpoints

  • Direct secure messaging: rmanfready1017450@direct.unitypoint.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1710419122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-234-5990",
            "fax_number": "319-234-5994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Harrison St Ste 207",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123988",
            "country_code": "US",
            "telephone_number": "312-942-5861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANFREADY",
        "first_name": "RICHARD",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.152697",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "MD-51934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.