Surya Manivannan, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

2022-01910 Issued in NC

Practice address

102 Mason Farm Rd
Chapel Hill, NC 27599-6134

Phone

(919) 966-1459

NPI assigned

Apr 28, 2017

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nephrology

Education

West Virginia University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC - Bma of Burlington Inc Dialysis facility, Burlington, NC, CCN 342533
• DaVita North Burlington Dialysis Dialysis facility, Burlington, NC, CCN 342686
• Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of North Carolina at Chapel Hill

  dba UNC Faculty Physicians

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment Care Compare group NPD
• Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1619150141
  NPD (past)

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

• Bio-Medical Applications of North Carolina, Inc.

  dba Bma Burlington

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, NC
  • NPI 1104938935

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  dba North Burlington Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, NC
  • NPI 1134407067

  Dialysis facility

  Care Compare affiliation Name & address match
• University of North Carolina Hospitals at Chapel Hill

  dba UNC Hospitals

  • General Acute Care Hospital
  • Chapel Hill, NC
  • NPI 1932208576
  Care Compare affiliation

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1801321708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275996134",
            "telephone_number": "919-966-1459",
            "fax_number": "919-843-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275996134",
            "telephone_number": "919-966-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIVANNAN",
        "first_name": "SURYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "227552",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2022-01910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smanivannan306989@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Mangum, LCMHCA
• Ronald Lee Mangum, LCAS
• Arpita Suketu Maniar, M.B.B.S, MD
• Manijeh Boustani, PH.D., Inc.
• Alison Elizabeth Manikowski, PSY.D.
• Jean B Mankowski, PHD
• Devan Michael Manley
• Ashley E Manlove, D.M.D., M.D.
• George H Manlove, D.C.
• Monica Constance Mann-Wrobel, PH.D.

• Nephrology Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Nephrology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.