NPIMap

Individual provider Active NPI

Earnest George Manjooran, MD

  • Internal Medicine Physician
  • Roseville, CA
National Provider Identifier
1750471546
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C133271 Issued in CA
Practice address
588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2842
Phone
(916) 781-9885
Fax
(916) 781-7923
NPI assigned
Oct 13, 2006
Last updated
May 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33822 AZ
Internal Medicine Physician 207R00000X C133271 CA Primary

Addresses

Primary practice location

588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2842

Mailing address

588 N Sunrise Ave
Suite 120
Roseville, CA 95661-2842
Phone (916) 781-9885

Other identifiers 2

IdentifierTypeStateIssuer
C133271OtherCAMEDICAL LICENSE
923517MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150721000062 CA Practitioner - Internal Medicine 6002851276 Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

588 N Sunrise Ave
Roseville, CA 95661-2843
Phone (916) 781-9885

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.18 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
73.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C133271CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Associates of Lewistown Past Accepting new patients
Carondelet Health Network Past Accepting new patients
Carondelet Health Network Past Accepting new patients
Tucson Medical Center Past Accepting new patients
Jose R. Acosta, M.D., P.C. Internal Medicine Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1750471546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 N SUNRISE AVE",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612842",
            "telephone_number": "916-781-9885",
            "fax_number": "916-781-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 N SUNRISE AVE",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612842",
            "telephone_number": "916-781-9885",
            "fax_number": "916-781-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANJOORAN",
        "first_name": "EARNEST",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33822",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C133271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C133271",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "923517",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.