Active NPI
Manohar Kola, M.D.
- Cardiovascular Disease Physician
- Decatur, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036071409
- Practice address
- 1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800 - Phone
- (217) 422-6100
- Fax
- (833) 784-5326
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 036-071409 | IL | |
| Cardiovascular Disease Physician | 207RC0000X | 036071409 | IL | Primary |
Addresses
Primary practice location
1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800
Mailing address
1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800
Phone (217) 422-6100
Other practice location 1
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 422-6100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036071409 | Medicaid | IL | |
| 060040114 | Other | IL | RAILROAD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mkola100015@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 464-2966
1800 E Lake Shore Dr 6TH FLR
Decatur, IL 62521-3810
Phone (217) 422-6100
2 W Adams St
Sullivan, IL 61951-1943
Phone (217) 728-8316
2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 422-6100
619 E Mason St
Springfield, IL 62701-1034
Phone (217) 788-0706
Hospital & facility affiliations
- St Marys Hospital
- Decatur Memorial Hospital
- St Johns Hospital
- HSHS Good Shepherd Hospital Inc
- St Anthonys Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.81 of 100
- Quality
- 85.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-071409 | IL | MD | Specialist |
| 036071409 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Cardiovascular Consultants LTD | Cardiovascular Disease | Current | Accepting new patients |
| St Marys Hospital Decatur of the Hospital Sisters of the Third Order | Current | Accepting new patients |
Locations
409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565
1770 E Lake Shore Dr
Ste 105
Decatur, IL 62521
Phone (217) 329-1000
2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000
1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729
503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121
3 Saint Elizabeth Blvd
Ste 2800
O Fallon, IL 62269
Phone (618) 233-6044
619 E Mason St
#4P57
Springfield, IL 62701
619 E Mason St
Ste 4
Springfield, IL 62701
619 E Mason St
Ste 4P57
Springfield, IL 62701
3051 Hollis Dr
Springfield, IL 62704
Phone (217) 523-5406
Interoperability endpoints
- mkola100015@ewd.direct.hshs.org
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1982714218
Cardiovascular Disease
-
dba St Marys Hospital
- General Acute Care Hospital
- Decatur, IL
- NPI 1326041229
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Decatur, IL
- NPI 1548357973
-
- Critical Access Hospital
- Shelbyville, IL
- NPI 1053348532
-
dba St. Anthony's Memorial Hospital
- General Acute Care Hospital
- Effingham, IL
- NPI 1306800602
-
dba St. Anthony's Memorial Hospitral
- Clinic/Center
- Effingham, IL
- NPI 1881214104
Hospital
-
dba HSHS St. John's Hospital
- General Acute Care Hospital
- Springfield, IL
- NPI 1205818481
-
dba St Marys Hospital
- General Acute Care Hospital
- Decatur, IL
- NPI 1326041229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1982786273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1770 E LAKE SHORE DR STE 105",
"city": "DECATUR",
"state": "IL",
"postal_code": "625213800",
"telephone_number": "217-422-6100",
"fax_number": "833-784-5326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1770 E LAKE SHORE DR STE 105",
"city": "DECATUR",
"state": "IL",
"postal_code": "625213800",
"telephone_number": "217-422-6100",
"fax_number": "833-784-5326"
}
],
"practiceLocations": [
{
"address_1": "1800 E Lake Shore Dr",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "IL",
"postal_code": "625213810",
"country_code": "US",
"telephone_number": "217-422-6100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOLA",
"first_name": "MANOHAR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2021-12-23",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "036-071409",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036071409",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036071409",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "060040114",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mkola100015@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "1770 E Lake Shore Dr Ste 105",
"city": "Decatur",
"state": "IL",
"country_code": "US",
"postal_code": "625213800",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.