Individual provider Active NPI

Alexis Marie Manneh, PA-C

  • Physician Assistant
  • Emeryville, CA
National Provider Identifier
1740553056
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21689 Issued in CA
Practice address
2100 Powell St Ste 900
Emeryville, CA 94608-1844
Phone
(510) 350-2600
NPI assigned
Feb 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21689 CA Primary

Addresses

Primary practice location

2100 Powell St Ste 900
Emeryville, CA 94608-1844

Mailing address

5741 W Crowley Ave
Visalia, CA 93291-5146
Phone (818) 317-8165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000220 CA Practitioner - Physician Assistant 8224292180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21689CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Apr 1, 2012 Accepting new patients
Cep America - California CurrentSince Nov 1, 2014 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

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.

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1740553056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 W CROWLEY AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915146",
            "telephone_number": "818-317-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNEH",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.