Individual provider Active NPI

Manika Bhateja, M.D

  • Pediatrics Physician
  • Lakeville, MN
National Provider Identifier
1902035777
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
70561 Issued in MN
Practice address
18580 Joplin Ave
Lakeville, MN 55044-4218
Phone
(952) 892-9555
NPI assigned
Jul 14, 2009
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301094895 MI
Pediatrics Physician 208000000X 036-130722 IL
Pediatrics Physician 208000000X 70561 MN Primary

Addresses

Primary practice location

18580 Joplin Ave
Lakeville, MN 55044-4218

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866
Phone (776) 696-7150

Other identifiers 3

IdentifierTypeStateIssuer
036130722OtherILIL PHYSICIAN LICENSE
036130722MedicaidIL
070OtherILTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220113000957 MN Practitioner - Pediatric Medicine 5395995781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

18580 Joplin Ave
Lakeville, MN 55044-4218
Phone (952) 892-9500

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-130722ILMDPediatrics Physician
4301094895MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2022 Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2022 Accepting new patients
Fairview Clinics Past Accepting new patients
Fairview Express Care Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

18580 Joplin Ave
Lakeville, MN 55044
Phone (952) 892-9500

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

4151 Willowwood St SE
Prior Lake, MN 55372
Phone (952) 226-2600

Interoperability endpoints

  • Direct secure messaging: mbhateja704044@fairview.direct-ci.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1902035777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "776-696-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18580 JOPLIN AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444218",
            "telephone_number": "952-892-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATEJA",
        "first_name": "MANIKA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2023-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301094895",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-130722",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "70561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL PHYSICIAN LICENSE",
            "identifier": "036130722",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130722",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "070",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.