Michael J Manalo, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

04-26424 Issued in KS

Practice address

615 S New Ballas Rd Dept of
Saint Louis, MO 63141-8221

Phone

(314) 251-6000

Fax

(636) 200-4243

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Western Anesthesiology Associates, Inc.

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1275646754
  Medicare reassignment NPD
• Midwest Anesthesia Associates, PA

  • Anesthesiology Physician
  • Shawnee Mission, KS
  • NPI 1336192392
  Medicare reassignment NPD
• Northstar Anesthesia of Missouri, LLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1396191789

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1912973819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD DEPT OF",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000",
            "fax_number": "636-200-4243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6560 High Dr",
            "address_purpose": "LOCATION",
            "city": "Mission Hills",
            "state": "KS",
            "postal_code": "662081936",
            "country_code": "US",
            "telephone_number": "636-386-9224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANALO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "04-26424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "50044840",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100266320A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207973322",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Man
• Rachel L Mana, COTA/L
• Chibuzo Charles-Mendel Manafa
• Adam Manahan
• Alvin R. Manalaysay, M.D.
• William Troy Manard, MD
• Mark J Manary, MD
• Manchester Ambulatory Surgery Center LP
• Jennifer A Mancuso, COTA/L
• Mandala Medical Services, LLC

• Anesthesiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.