Divya Mani, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61180970 Issued in WA

Practice address

1221 E State St
Rockford, IL 61104-2231

Phone

(815) 972-1000

Fax

(815) 972-1091

NPI assigned

Jun 19, 2018

Last updated

Feb 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Sound Inpatient Physicians PLLCGroup PAC ID 5991618738, 424 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• South Sound Inpatient Physicians PLLC

  dba Sound Inpatient Physicians

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Washington, PC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1861430522

  Family Medicine

  NPD
• South Sound Inpatient Physicians PLLC

  dba Sound Inpatient Physicians

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789

  Family Medicine

  NPD
• South Sound Inpatient Physicians, PLLC

  • Hospitalist Physician
  • Coupeville, WA
  • NPI 1982035754

  Family Medicine

  NPD
• Multicare Health System

  dba Tacoma General Allenmore

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  dba Tacoma General Allenmore

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1881188217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1000",
            "fax_number": "815-972-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1000",
            "fax_number": "815-972-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANI",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125-073178",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61180970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishna K R Manda, MD
• Kris James Manders
• Manish Prajwal Mane Manohar, M.D.
• Roxana Koren Manger, APN
• Manhattan Dental Associates PC
• Vishnu Raj Kumar Mani, M.D.
• Michael J Manley, M.D.
• Nicholas J Manno, MD
• Zlatina Manov, MD
• Monica A Manring, PT

• Family Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.