NPIMap

Individual provider Active NPI

Maria C Manalo, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1730121096
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11659 Issued in NV
Practice address
540 N Nellis Blvd
Las Vegas, NV 89110-5368
Phone
(702) 877-5199
NPI assigned
Jun 12, 2006
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11659 NV Primary

Addresses

Primary practice location

540 N Nellis Blvd
Las Vegas, NV 89110-5368

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other identifiers 4

IdentifierTypeStateIssuer
100508995MedicaidNV
1730121096OtherNVSMA MEDICAID
V110779OtherNVSMA MEDICARE
100508996MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060424000045 NV Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7618946005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone (702) 579-3253

540 N Nellis Blvd
Las Vegas, NV 89110-5368
Phone (702) 579-3253

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group Coats LTD Internal Medicine Current Accepting new patients
Southwest Medical Associates, Inc Internal Medicine CurrentSince Jun 19, 2010 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 9, 2019 Accepting new patients
Optum Medical Group II Rhodes P C Internal Medicine CurrentSince Jun 9, 2019 Accepting new patients
McLaren Medical Group Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Rey Alberto Franco MD PC Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Woodland Health Care Services PC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

540 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 459-7424

5580 W Flamingo Rd
Las Vegas, NV 89103
Phone (702) 854-3160

Interoperability endpoints

  • Direct secure messaging: mmanalo119407@westdirect.optum.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1730121096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105368",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALO",
        "first_name": "MARIA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508995",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMA MEDICAID",
            "identifier": "1730121096",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMA MEDICARE",
            "identifier": "V110779",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508996",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.