| Vivek K Manchanda, MD | |
|
4122 Keaton Crossing Blvd, Suite 102, O Fallon, MO 63368-8218 | |
| (636) 329-9077 | |
| (636) 329-9076 |
| Full Name | Vivek K Manchanda |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 26 Years |
| Location | 4122 Keaton Crossing Blvd, O Fallon, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083729941 | NPI | - | NPPES |
| 431560263 | Other | MO | TRICARE WEST |
| P01433382 | Other | MO | RAILROAD MEDICARE PROVIDER PTAN |
| 7233350001 | Other | MO | NORIDIAN , MEDICARE DME |
| P00836305 | Other | RAILROAD MEDICARE | |
| 1083729941 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 2006017511 (Missouri) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | 2006017511 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fayette County Hospital | Vandalia, IL | Hospital |
| Perry County Memorial Hospital | Perryville, MO | Hospital |
| Madison Medical Center | Fredericktown, MO | Hospital |
| Pike County Memorial Hospital | Louisiana, MO | Hospital |
| Washington County Memorial Hospital | Potosi, MO | Hospital |
| Entity Name | Madison Medical Center Stockhoff Memorial Nursing Home |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720163025 PECOS PAC ID: 1355255886 Enrollment ID: O20031118000558 |
| Entity Name | Washington County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194838821 PECOS PAC ID: 3476456880 Enrollment ID: O20040131000146 |
| Entity Name | Pike County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437265311 PECOS PAC ID: 8123015518 Enrollment ID: O20070410000136 |
| Entity Name | Elpis Pain Management Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841544251 PECOS PAC ID: 5193978328 Enrollment ID: O20130118000436 |
| Entity Name | Mercy Hospital Perry |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063117158 PECOS PAC ID: 1153777826 Enrollment ID: O20231101001515 |
| Mailing Address | Practice Location Address |
|---|---|
| Vivek K Manchanda, MD 4122 Keaton Crossing Blvd, Suite 102, O Fallon, MO 63368-8218 Ph: (636) 329-9077 | Vivek K Manchanda, MD 4122 Keaton Crossing Blvd, Suite 102, O Fallon, MO 63368-8218 Ph: (636) 329-9077 |