NPIMap

Individual provider Active NPI

Thomas Crellin Manning, MD

  • Neurological Surgery Physician
  • Boise, ID
National Provider Identifier
1861501637
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M9928 Issued in ID
Practice address
6140 W Curtisian Ave Ste 400
Boise, ID 83704-8907
Phone
(208) 327-5600
Fax
(208) 327-5602
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X M9928 ID Primary

Addresses

Primary practice location

6140 W Curtisian Ave Ste 400
Boise, ID 83704-8907

Mailing address

6140 W Curtisian Ave Ste 400
Boise, ID 83704-8907
Phone (208) 327-5600

Other practice location 1

3875 E Overland Rd
Meridian, ID 83642-9005
Phone (208) 327-5600

Other identifiers 6

IdentifierTypeStateIssuer
8944944OtherCRIMES VICTIMS
1861501637MedicaidID
20140OtherIDBLUE CROSS OF IDAHO
006154OtherOMAP
0222532OtherIDWA DEPT OF LABOR
100001035500OtherIDREGENCE BLUESHIELD OF IDAHO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140224002176 ID Practitioner - Neurosurgery 2961593470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Chicago, Pritzker School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manning Neurosurgery, PLLCGroup PAC ID 3870722051, 3 clinicians

Practice addresses (Care Compare)

6140 W Curtisian Ave
Boise, ID 83704-8907

Hospital & facility affiliations

  • Treasure Valley Hospital Hospital, Boise, ID, CCN 130063
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Luke'S McCall Hospital, McCall, ID, CCN 131312
  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion56
Laminectomy or laminotomy (partial removal of spine bones)46

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Manning Neurosurgery, PLLC Neurological Surgery CurrentSince Jan 1, 2014 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

8800 W Emerald St
Boise, ID 83704
Phone (208) 373-5000

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

6140 W Curtisian Ave
Ste 400
Boise, ID 83704
Phone (208) 327-5600

3875 E Overland Rd
Meridian, ID 83642
Phone (208) 327-5600

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Treasure Valley HospitalBoise, ID, CCN 130063 Hospital Limited Partnership Interest (3.22%) Jun 28, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 10

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1861501637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 W CURTISIAN AVE STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048907",
            "telephone_number": "208-327-5600",
            "fax_number": "208-327-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 W CURTISIAN AVE STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048907",
            "telephone_number": "208-327-5600",
            "fax_number": "208-327-5602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3875 E Overland Rd",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836429005",
            "country_code": "US",
            "telephone_number": "208-327-5600",
            "fax_number": "208-327-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNING",
        "first_name": "THOMAS",
        "middle_name": "CRELLIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M9928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIMES VICTIMS",
            "identifier": "8944944",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861501637",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "20140",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "006154",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LABOR",
            "identifier": "0222532",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD OF IDAHO",
            "identifier": "100001035500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.