| Manhattan Medical Group, Llc | |
|
200 Research Dr Manhattan KS 66503-3049 | |
| (785) 539-4644 | |
| (785) 539-8010 |
| Full Name | Manhattan Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Research Dr, Manhattan, Kansas |
| Authorized Official Name and Position | Margaret Matson (PRACTICE MANAGER) |
| Authorized Official Contact | 7855394644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manhattan Medical Group, Llc 200 Research Dr Manhattan KS 66503-3049 Ph: (785) 539-4644 | Manhattan Medical Group, Llc 200 Research Dr Manhattan KS 66503-3049 Ph: (785) 539-4644 |
| NPI Number | 1609138387 |
|---|---|
| Provider Enumeration Date | 06/08/2012 |
| Last Update Date | 02/20/2019 |
| Medicare PECOS PAC ID | 3870742505 |
|---|---|
| Medicare Enrollment ID | O20121012000345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609138387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207RI0011X | Internal Medicine - Interventional Cardiology | (* (Not Available)) | Primary |
| Provider Name | Priyantha S Ranaweera |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497952998 PECOS PAC ID: 9638263551 Enrollment ID: I20070921000556 |
| Provider Name | Tyson Ryley Nickelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972194751 PECOS PAC ID: 7517372253 Enrollment ID: I20210210003081 |
| Provider Name | Rebecca Lynne Haugaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396315636 PECOS PAC ID: 7113329251 Enrollment ID: I20210712002071 |
| Provider Name | Joshua B Wichman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770234064 PECOS PAC ID: 1355733460 Enrollment ID: I20220124001329 |
| Provider Name | Emily Elizabeth Ebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780300848 PECOS PAC ID: 4183091739 Enrollment ID: I20221110001679 |
| Provider Name | Amanda C A Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831974351 PECOS PAC ID: 4981068319 Enrollment ID: I20230918002953 |
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