Manus Praserthdam, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME33665 Issued in FL

Practice address

1201 5TH Ave N
Suite 208
St Petersburg, FL 33705-1400

Phone

(727) 894-1122

Fax

(727) 894-0033

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Manus Praserthdam,M.D.,P.a

  • Specialist
  • St Petersburg, FL
  • NPI 1376770826
  NPD (past) Authorized official
• Rai Care Centers of Florida II, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • St. Petersburg, FL
  • NPI 1235148214
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891787917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 208",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-894-1122",
            "fax_number": "727-894-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 208",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-894-1122",
            "fax_number": "727-894-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASERTHDAM",
        "first_name": "MANUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME33665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3106012",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0184828",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0666950",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "212769",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ppec of FL St. Pete, LLC
• Ppec of FL Support, LLC
• Janika Prajapati, MD
• Purna Prasad, PHARMD
• Dan Prasatthong, D.D.S.
• William Russell Prather, MD
• Prathna Inc
• Jerrilynn Pratt-Mullen
• Amanda Pratt, LCSW
• Stacy Pratt, ARNP FNP-C

• Specialist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.