Individual provider Active NPI

Manoj Mohan, D.O.

  • Allergy & Immunology Physician
  • Okemos, MI
National Provider Identifier
1821295213
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MM018049 Issued in MI
Practice address
3955 Okemos Rd
Ste A1
Okemos, MI 48864-4208
Phone
(517) 349-0027
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MM018049 MI Primary

Addresses

Primary practice location

3955 Okemos Rd
Ste A1
Okemos, MI 48864-4208

Mailing address

3955 Okemos Rd
Ste A1
Okemos, MI 48864-4208
Phone (517) 349-0027

Other identifiers 2

IdentifierTypeStateIssuer
002434OtherGARESIDENT- FELLOW
5101018049OtherMISTATE OF MICHIGAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090619000476 MI Practitioner - Allergy/Immunology 8527119270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Mid West Medical College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3955 Okemos Rd
Suite A1
Okemos, MI 48864-3797
Phone (517) 349-0027

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MM018049MIMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Okemos Allergy Center, P.C. CurrentSince Jul 1, 2009 Accepting new patients

Locations

3955 Okemos Rd
Ste A1
Okemos, MI 48864
Phone (517) 349-0027

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1821295213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 OKEMOS RD",
            "address_2": "STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644208",
            "telephone_number": "517-349-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 OKEMOS RD",
            "address_2": "STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644208",
            "telephone_number": "517-349-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "MM018049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENT- FELLOW",
            "identifier": "002434",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSE",
            "identifier": "5101018049",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.