Individual provider Active NPI

Manna Mary Varghese, M.D.

  • Emergency Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1790314375
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0097019 Issued in MD
Practice address
301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone
(410) 318-9147
NPI assigned
Apr 6, 2020
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0097019 MD Primary

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061-5803

Mailing address

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 318-9147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230928002156 MD Practitioner - Emergency Medicine 7911351671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baltimore Washington Emergency Physicians, Inc.Group PAC ID 3577451103, 31 clinicians

Practice addresses (Care Compare)

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 787-4565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0097019MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Washington Emergency Physicians, Inc. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

Interoperability endpoints

  • Direct secure messaging: mvarghese646947@direct.umm.edu

Organizations & group practices 1

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 1

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1790314375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-318-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-318-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "MANNA",
        "middle_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0097019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.