Individual provider Active NPI

Manuel Enecilla, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1811928088
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
240583 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-4403
Fax
(212) 315-0196
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 240583 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

1790 Broadway
3Rd Floor
New York, NY 10019-1412
Phone (212) 315-0144

Other identifiers 1

IdentifierTypeStateIssuer
240583OtherNYLICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address menecilla182867@direct.urmc.rochester.edu Direct
Direct Messaging Address menecilla182867@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070227000512 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2961504659 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Hospital of RochesterGroup PAC ID 5496641631, 403 clinicians

Practice addresses (Care Compare)

1000 S Ave
Rochester, NY 14620-2733
Phone (585) 341-6776

Hospital & facility affiliations

  • Highland Hospital Hospital, Rochester, NY, CCN 330164
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
89.84 of 100Reported as group
Quality
68.36
Promoting interoperability
100
Improvement activities
40
Cost
81.1

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Sep 7, 2019 Accepting new patients
Internal Medicine Group Internal Medicine CurrentSince Mar 22, 2020 Accepting new patients
Internal Medicine Group CurrentSince Mar 22, 2020 Accepting new patients
Soldiers & Sailors Memorial Hospital CurrentSince Dec 17, 2012 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients
Soldiers & Sailors Memorial Hospital CurrentSince Dec 17, 2012 Accepting new patients
University of Rochester Department of Psychiatry Clinical Group Internal Medicine CurrentSince Sep 7, 2019 Accepting new patients
Highland Hospital of Rochester Internal Medicine CurrentSince Sep 7, 2019 Accepting new patients
St Lukes Roosevelt Community Care Internal Medicine Past Accepting new patients
Slrhc Faculty Practice Internal Medicine Past Accepting new patients

Locations

8000 Box
Buffalo, NY 14267
Phone (716) 213-0772

196 North St
Geneva, NY 14456
Phone (315) 787-4156

418 N Main St
Penn Yan, NY 14527
Phone (315) 531-2000

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Interoperability endpoints

  • Direct secure messaging: menecilla182867@direct.urmc.rochester.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1811928088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 BROADWAY",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191412",
            "telephone_number": "212-315-0144",
            "fax_number": "212-315-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-4403",
            "fax_number": "212-315-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENECILLA",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "240583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "240583",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "menecilla182867@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "menecilla182867@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.