Wayne Kenneth Manness, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036-099816 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0914

Phone

(309) 655-2000

NPI assigned

May 9, 2006

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Diagnostic Radiology

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093
• Osf Saint Anthony's Health Center Hospital, Alton, IL, CCN 140052

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Central Illinois Radiological Associates, LTD.

  dba Central Illinois Radiological Associates

  • Diagnostic Radiology Physician
  • Peoria, IL
  • NPI 1538192828
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Cira Michigan PC

  • Diagnostic Radiology Physician
  • Escanaba, MI
  • NPI 1972141513

  IL

  Medicare reassignment Care Compare group NPD
• Diaspora Radiology, SC

  dba Smart Scan Medical Imaging, SC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Northbrook, IL
  • NPI 1730652017

  Diagnostic Radiology

  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314

  Diagnostic Radiology

  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Arlington Heights Radiology Center, LLC

  • Specialist
  • Arlington Heights, IL
  • NPI 1851302699
  NPD (past)
• City of Hope Medical Group of Illinois PLLC

  • Specialist
  • Zion, IL
  • NPI 1548258072
  NPD (past)
• Quakerbridge Radiology Associates PA

  • Diagnostic Radiology Physician
  • Mercerville, NJ
  • NPI 1124027909
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  dba OSF Sacred Heart Medical Center

  • General Acute Care Hospital
  • Danville, IL
  • NPI 1699288449
  Care Compare affiliation
• Osf Healthcare System

  dba Osf Saint Anthony's Health Center

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1710396932
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1710936497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370914",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1709 Jumer Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617040914",
            "country_code": "US",
            "telephone_number": "309-665-0640",
            "fax_number": "309-665-0657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNESS",
        "first_name": "WAYNE",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101242387",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.091090",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D00661190",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA06727700",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD057715L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-099816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099816",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "212545",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "202926",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James R Mangerson, PA-C
• Madeline Mangieri, M.S. CCC-SLP/L
• Aleena E Mangold
• Robin L Maniurski, MD
• Jennifer Mann, LCSW
• Kristen L Manning, CRNA
• Haig Hagop Manougian, M.D.
• Maryah Mansoor, MD
• Sarah Manzoor, MD
• Claire Abbott Maquet, LCPC

• Diagnostic Radiology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.