NPIMap

Individual provider Active NPI

Manoj Bhattarai, MD

  • Nephrology Physician
  • Royal Palm Beach, FL
National Provider Identifier
1881905925
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME124542 Issued in FL
Practice address
11301 Okeechobee Blvd
Suite 5a
Royal Palm Beach, FL 33411-8719
Phone
(561) 283-0384
Fax
(561) 282-3238
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP01913 RI
Nephrology Physician 207RN0300X ME124542 FL Primary

Addresses

Primary practice location

11301 Okeechobee Blvd
Suite 5a
Royal Palm Beach, FL 33411-8719

Mailing address

11301 Okeechobee Blvd
Suite 5a
Royal Palm Beach, FL 33411-8719
Phone (561) 283-0384

Other identifiers 1

IdentifierTypeStateIssuer
017232000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160819002329 FL Practitioner - Nephrology 7113233602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Specialists of the Palm Beaches LLCGroup PAC ID 4880632421, 5 clinicians
Palm Beach Elder Care LLCGroup PAC ID 7214361237, 5 clinicians

Practice addresses (Care Compare)

11301 Okeechobee Blvd
5A
Royal Palm Beach, FL 33411-8719
Phone (561) 868-4846

8953 Cypress Grove LN
Royal Palm Beach, FL 33411-3725
Phone (561) 685-1522

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME124542FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Internal Medicine Current Accepting new patients
Palm Beach Elder Care LLC Internal Medicine CurrentSince Dec 3, 2019 Accepting new patients

Locations

13005 State Road 80
Ste 225
Loxahatchee, FL 33470
Phone (561) 313-4884

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: manoj.bhattarai@3079.securemail.prognocis.com
  • Direct secure messaging: lmcmbhatt@yourcarecommunity.org
  • Direct secure messaging: manojbhattarai@tdh.allscriptsdirect.net

Organizations & group practices 3

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 9

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1881905925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 OKEECHOBEE BLVD",
            "address_2": "SUITE 5A",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118719",
            "telephone_number": "561-283-0384",
            "fax_number": "561-282-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 OKEECHOBEE BLVD",
            "address_2": "SUITE 5A",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118719",
            "telephone_number": "561-283-0384",
            "fax_number": "561-282-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTARAI",
        "first_name": "MANOJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP01913",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME124542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017232000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.