Individual provider Active NPI

Seetharam Reddy Mannem, MD., MRCPUK

  • Internal Medicine Physician
  • Rock Island, IL
National Provider Identifier
1801459045
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
158857 Issued in IL
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(309) 779-5000
NPI assigned
Apr 14, 2019
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 158857 IL Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

12 N 7TH Ave
Mount Vernon, NY 10550-2026

Other practice location 1

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-5000

Other names 1

  • Dr. Seetharam Reddy Mannem Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220830002126 IL Practitioner - Internal Medicine 6406230127 Reassigns benefits to 1 organization
I20220910000508 IA Practitioner - Hospitalist 6406230127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2701 17TH St
Rock Island, IL 61201-5393
Phone (309) 779-5000

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (309) 779-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158857ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Internal Medicine CurrentSince Aug 29, 2022 Accepting new patients
Trinity Medical Center Past Accepting new patients
Trinity Medical Center Past Accepting new patients
Unity Healthcare Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Interoperability endpoints

  • Direct secure messaging: smannem901819@direct.unitypoint.org

Organizations & group practices 5

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1801459045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Utica Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527221626",
            "country_code": "US",
            "telephone_number": "563-742-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNEM",
        "first_name": "SEETHARAM",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD., MRCPUK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "158857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEETHARAM",
            "last_name": "MANNEM",
            "middle_name": "REDDY",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.