Individual provider Active NPI

Manjaree Daw, MD

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1972587038
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME160719 Issued in FL
Practice address
10080 SW Innovation Way
Port St Lucie, FL 34987-2127
Phone
(407) 580-5052
Fax
(407) 580-5052
NPI assigned
Dec 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME160719 FL Primary

Addresses

Primary practice location

10080 SW Innovation Way
Port St Lucie, FL 34987-2127

Mailing address

10080 SW Innovation Way
Port St Lucie, FL 34987-2127
Phone (407) 580-5052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050902000101 FL Practitioner - Internal Medicine 2769414499 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Memorial Medical Center IncGroup PAC ID 2961300611, 514 clinicians

Practice addresses (Care Compare)

1095 NW Saint Lucie W Blvd
Suite 104
Port Saint Lucie, FL 34986
Phone (772) 785-5511

Hospital & facility affiliations

  • Anchor Home Health Services, LLC Home health agency, Stuart, FL, CCN 107747
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME160719FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Mar 29, 2023 Accepting new patients
Martin Memorial Medical Center Inc CurrentSince Jan 16, 2025 Accepting new patients
Saint Francis Care Medical Group, PC Past Accepting new patients
Orlando Health Inc Internal Medicine Past Accepting new patients

Locations

1095 NW Saint Lucie West Blvd
#L
Port St Lucie, FL 34986
Phone (772) 785-5595

1095 NW Saint Lucie West Blvd
Ste 104
Port St Lucie, FL 34986
Phone (772) 785-5511

1095 NW Saint Lucie West Blvd
Ste 108
Port St Lucie, FL 34986
Phone (561) 785-5580

10080 SW Innovation Way
Ste 201
Port St Lucie, FL 34987
Phone (772) 344-3811

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1972587038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872127",
            "telephone_number": "407-580-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872127",
            "telephone_number": "407-580-5052",
            "fax_number": "407-580-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAW",
        "first_name": "MANJAREE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.