Individual provider Active NPI

Pius Manavalan, MD

  • Nephrology Physician
  • Hamilton, OH
National Provider Identifier
1972576569
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-08-0215M Issued in OH
Practice address
3090 McBride CT, Suite B
Hamilton, OH 45011
Phone
(513) 863-8212
Fax
(513) 863-8379
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-08-0215M OH Primary

Addresses

Primary practice location

3090 McBride CT, Suite B
Hamilton, OH 45011

Mailing address

3090 McBride CT, Suite B
Hamilton, OH 45011
Phone (513) 863-8212

Other identifiers 1

IdentifierTypeStateIssuer
2288171MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090403000234 OH Practitioner - NephrologyPractitioner - Internal Medicine 7113074394 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Assoc of SW Ohio Inc Nephrology Current Accepting new patients
Nephrology Associates of Southwestern Ohio, Inc Nephrology CurrentSince Dec 1, 2001 Accepting new patients
Tyler Emergency Physicians Past Accepting new patients

Locations

2960 Mack Rd
Ste 203
Fairfield, OH 45014
Phone (513) 791-6099

3090 McBride Ct
Ste B
Hamilton, OH 45011
Phone (513) 863-8212

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1048/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1972576569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 MCBRIDE CT, SUITE B",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "45011",
            "telephone_number": "513-863-8212",
            "fax_number": "513-863-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 MCBRIDE CT, SUITE B",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "45011",
            "telephone_number": "513-863-8212",
            "fax_number": "513-863-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAVALAN",
        "first_name": "PIUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-08-0215M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2288171",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

Verify at the official NPI Registry.