NPIMap

Individual provider Active NPI

Manabendra Datta, M.D.

  • Hospitalist Physician
  • State College, PA
National Provider Identifier
1902872138
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD064993L Issued in PA
Practice address
1800 E Park Ave
State College, PA 16803-6709
Phone
(814) 231-7000
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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 MD064993L PA
Hospitalist Physician 208M00000X MD064993L PA Primary

Addresses

Primary practice location

1800 E Park Ave
State College, PA 16803-6709

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other practice location 1

210 Medical Center Dr
Philipsburg, PA 16866-1948
Phone (814) 342-5402

Other identifiers 1

IdentifierTypeStateIssuer
001717341MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdatta66548@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040226000194 PA Practitioner - HospitalistPractitioner - Internal Medicine 0244126258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

Hospital & facility affiliations

  • Mount Nittany Medical Center Hospital, State College, PA, CCN 390268
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD064993LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Internal Medicine CurrentSince Jan 15, 2014 Accepting new patients
Geisinger Clinic CurrentSince Jan 15, 2014 Accepting new patients
Geisinger Clinic Current Accepting new patients
Mount Nittany Medical Center Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

210 Medical Center Dr
Philipsburg, PA 16866
Phone (814) 342-8001

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

Interoperability endpoints

  • Direct secure messaging: mdatta66548@direct.geisinger.edu

Organizations & group practices 4

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1902872138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036709",
            "telephone_number": "814-231-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Philipsburg",
            "state": "PA",
            "postal_code": "168661948",
            "country_code": "US",
            "telephone_number": "814-342-5402",
            "fax_number": "814-342-0598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATTA",
        "first_name": "MANABENDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD064993L",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD064993L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001717341",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdatta66548@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 E Park Ave",
            "city": "State College",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168036709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.