Manjula Kottapalli, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35.081604 Issued in OH

Practice address

6140 S Broadway
Lorain, OH 44053

Phone

(440) 233-7232

Fax

(440) 204-4315

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, FL2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riveon Mental Health and RecoveryGroup PAC ID 1557312535, 30 clinicians

Advanced Psychiatric Group PAGroup PAC ID 0446556716, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: manjula.kottapalli@hca4.eclinicaldirectplus.com

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.

• Riveon Mental Health and Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lorain, OH
  • NPI 1841268281
  Medicare reassignment Care Compare group NPD
• Advanced Psychiatric Group, PA

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Orlando, FL
  • NPI 1316016637
  Medicare reassignment Care Compare group NPD
• State of Ohio Office of Budget and Management State Accounting

  • Psychiatric Hospital
  • Cincinnati, OH
  • NPI 1023082716
  Medicare reassignment NPD
• Riveon Mental Health and Recovery

  • Primary Care Clinic/Center
  • Lorain, OH
  • NPI 1376234914
  NPD
• State of Ohio Office of Budget and Management State Accounting

  • Psychiatric Hospital
  • Northfield, OH
  • NPI 1194799114
  NPD
• State of Ohio Office of Budget and Management State Accounting

  • Nursing Facility/Intermediate Care Facility
  • Sandusky, OH
  • NPI 1790732576
  NPD

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1730201229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-204-4315",
            "fax_number": "440-204-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44053",
            "telephone_number": "440-233-7232",
            "fax_number": "440-204-4315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 N Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Ravenna",
            "state": "OH",
            "postal_code": "442662218",
            "country_code": "US",
            "telephone_number": "330-296-5552 x265",
            "fax_number": "330-296-1310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6140 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Lorain",
            "state": "OH",
            "postal_code": "44053",
            "country_code": "US",
            "telephone_number": "440-233-7232",
            "fax_number": "440-204-4315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTTAPALLI",
        "first_name": "MANJULA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35-081604",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.081604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2546098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Grace Kordeleski, RN
• Kaitlyn Korn
• Jerry J Kosco
• Jeffrey J Kosiba, CDCA
• Celeste Kostelnik, DMD
• Amy Lynn Koutsopoulos
• Lawrence M Kovalcik, PA-C
• Carrie A. Kozak-Hietala, LISW
• Catherine Koziarz
• Delora Ann Kozusko, RN

• Psychiatry Physician in Lorain, OH
• Providers in Lorain, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.