Manohar Gajjela, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01081675A Issued in IN

Practice address

11109 Parkview Plaza Dr
Fort Wayne, IN 46845

Phone

(606) 726-6620

Fax

(260) 672-6639

NPI assigned

Jun 6, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Internal Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Physicians of Indiana PCGroup PAC ID 1052795986, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• The Orthopaedic Hospital of Lutheran Health Networ Hospital, Ft Wayne, IN, CCN 150168

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgajjela200663@direct.parkviewexchange.com

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.

• Hospitalist Physicians of Indiana, PC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1306576277

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Gary, IN
  • NPI 1528311149

  Internal Medicine

  Medicare reassignment NPD
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1184063257

  Internal Medicine

  NPD

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

• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Lutheran Musculoskeletal Center LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1174706576
  Care Compare affiliation

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1942594106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "606-726-6620",
            "fax_number": "260-672-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 Franklin Square Dr",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212373901",
            "country_code": "US",
            "telephone_number": "443-777-8186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 Franklin Square Dr",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212373901",
            "country_code": "US",
            "telephone_number": "443-777-8186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAJJELA",
        "first_name": "MANOHAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "77792",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MD",
            "license": "77792",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01081675A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgajjela200663@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terry M Gaff, MD
• Janel D Gagnon, MD
• Joyce Edna Gaines-Reese, MSW
• Jason T. Gaisford, PA-C
• Alexa Gaitan, RBT
• Logan Galbraith, PA-C
• Carol Burzon Galicia, PA
• Jeremy R. Gall, ATC
• Anisha Galla
• Daniel F Gallagher, MD

• Internal Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.