Active NPI
Sharanya Sai Manga
- Internal Medicine Physician
- Charleston, WV
National Provider Identifier
1750079620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 390200000X
- Practice address
- 3200 Maccorkle Ave SE
Charleston, WV 25304-1227 - Phone
- (304) 388-5590
- NPI assigned
- Apr 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 390200000X | WV | Primary |
Addresses
Primary practice location
3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Mailing address
1124 2ND St NW
Rochester, MN 55901-2758
Phone (214) 836-2698
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230711004587 | WV | Order and Referring Only - Internal Medicine | 0244699031 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | WV | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1750079620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1124 2ND ST NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559012758",
"telephone_number": "214-836-2698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 MACCORKLE AVE SE",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041227",
"telephone_number": "304-388-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGA",
"first_name": "SHARANYA",
"middle_name": "SAI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-27",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WV",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.