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 | 25 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 |
---|---|---|
Perry County Memorial Hospital | Perryville, MO | Hospital |
Fayette County Hospital | Vandalia, IL | 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 | Hannibal Clinic Operations, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427037225 PECOS PAC ID: 9931094182 Enrollment ID: O20040217001075 |
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 |