Manisha Surendra Raythatha, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

55506 Issued in AZ

Practice address

6424 E Broadway Rd Ste 101
Mesa, AZ 85206-1750

Phone

(480) 456-9000

NPI assigned

May 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1790046399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W ROSE GARDEN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272530",
            "telephone_number": "602-521-6252",
            "fax_number": "623-842-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6424 E BROADWAY RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061750",
            "telephone_number": "480-456-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYTHATHA",
        "first_name": "MANISHA",
        "middle_name": "SURENDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "55506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401584",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janine Ellen Raye
• Andrew T Rayer
• James Clayton Rayment, EDS NCSP
• Laurie Anne Raymond, LPC, MSC
• Rachel Ann Raymond, RDN, RD
• RCDC of Mesa PLC
• RDC Imaging PLLC
• Kylee A Read, OTR
• Emily Lynne Reader, SLPA
• Lawrence Robert Reader Jr., M.D.

• Diagnostic Radiology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.