Active NPI
Daniel Manfra, M.D.
- Psychiatry Physician
- Providence, RI
National Provider Identifier
1902252422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LP03585
- Practice address
- 345 Blackstone Blvd
Butler Campus - Box G-BH
Providence, RI 02906-4800 - Phone
- (401) 455-6375
- NPI assigned
- May 13, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LP03585 | RI | Primary |
Addresses
Primary practice location
345 Blackstone Blvd
Butler Campus - Box G-BH
Providence, RI 02906-4800
Mailing address
345 Blackstone Blvd
Butler Campus - Box G-BH
Providence, RI 02906-4800
Phone (401) 455-6375
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 6, 2024 through Dec 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1902252422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"address_2": "BUTLER CAMPUS - BOX G-BH",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"address_2": "BUTLER CAMPUS - BOX G-BH",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANFRA",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-13",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "LP03585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.