Individual provider Active NPI

Shahid A Manzar, MD

  • Student in an Organized Health Care Education/Training Program
  • Wilkes Barre, PA
National Provider Identifier
1851147904
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone
(570) 808-2340
Fax
(570) 808-7904
NPI assigned
Apr 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Mailing address

1153 Woodberry Dr
Mountain Top, PA 18707-9285
Phone (507) 601-8991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250611003543 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 4486164043

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1851147904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 WOODBERRY DR",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187079285",
            "telephone_number": "507-601-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-2340",
            "fax_number": "570-808-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZAR",
        "first_name": "SHAHID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.