DR. SHYAM PRABHAKANT MANI M.D.
NPI 1780029645
Internal Medicine in Houma, LA

NPI Status: Active since May 06, 2013

Contact Information

144 VALHI LAGOON XING
HOUMA, LA
ZIP 70360
Phone: (985) 262-1639
Fax: (985) 262-8197

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  • Individual
  • Male
  • Years of Experience 13
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SHYAM MANI

This page provides the complete NPI Profile along with additional information for Shyam Mani, an internist established in Houma, Louisiana with a medical specialization in Internal Medicine and more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1780029645 assigned on May 2013. The practitioner's primary taxonomy code is 207R00000X with license number 303437 (LA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1780029645
Provider Name
DR. SHYAM PRABHAKANT MANI M.D.
Gender
Male
Entity Type
Individual
Location Address
144 VALHI LAGOON XING HOUMA, LA 70360
Location Phone
(985) 262-1639
Location Fax
(985) 262-8197
Mailing Address
144 VALHI LAGOON XING HOUMA, LA 70360
Mailing Phone
(985) 262-1639
Mailing Fax
(985) 262-8197
Medical School Name
OTHER
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
05-06-2013
Last Update Date
09-13-2016
Code Navigator

An internist like Shyam Mani is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
303437
License State
LA
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (L) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (N) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (S) - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (H) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (L) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (N) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (S) HSA Eligible - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (L) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (N) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (S) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (H) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (L) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (N) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (S) - POS
  • Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
  • Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
  • Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
  • Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO
  • UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Shyam Mani is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Shyam Mani is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9133408545

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20161107002530

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.15 for a new patient copayment and $23.77 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 70360 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $124.6
  • Minimum New Patient Price $53.43
  • Maximum New Patient Price $164.73
  • Average New Patient Copayment $31.15
  • Minimum New Patient Copayment $13.35
  • Maximum New Patient Copayment $41.18

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.09
  • Minimum Established Patient Price $16.64
  • Maximum Established Patient Price $133.62
  • Average Established Patient Copayment $23.77
  • Minimum Established Patient Copayment $4.16
  • Maximum Established Patient Copayment $33.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Shyam Mani is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
TERREBONNE GENERAL MEDICAL CENTER - PARISH8166 MAIN STREET
HOUMA, LA 70360
(985) 873-4141Acute Care Hospitals
LEONARD J CHABERT MEDICAL CENTER1978 INDUSTRIAL BLVD
HOUMA, LA 70363
(985) 873-2200Acute Care Hospitals

Reviews for DR. SHYAM PRABHAKANT MANI M.D.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1780029645, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
4
Doubled → 8
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 0 → 0 9 → 18 → 9 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 6 + 0 + 0 + 2 + 1 + 8 + 6 + 8 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1780029645.

Other Providers at the Same Location


The following 18 providers are registered at the same or a nearby location.

Orthopaedic Surgery
144 VALHI LAGOON XING
HOUMA, LA 70360
Physical Therapist
144 VALHI LAGOON XING
HOUMA, LA 70360
Physical Therapist
144 VALHI LAGOON XING
HOUMA, LA 70360
Clinic/Center (Urgent Care)
144 VALHI LAGOON XING
HOUMA, LA 70360
Nurse Practitioner (Family)
144 VALHI LAGOON XING
HOUMA, LA 70360
Speech-Language Pathologist
144 VALHI LAGOON XING
HOUMA, LA 70360
Surgery
144 VALHI LAGOON XING
HOUMA, LA 70360
Nurse Practitioner (Family)
144 VALHI LAGOON XING
HOUMA, LA 70360
Family Medicine
144 VALHI LAGOON XING
HOUMA, LA 70360
Durable Medical Equipment & Medical Supplies
144 VALHI LAGOON XING
HOUMA, LA 70360
Specialist
144 VALHI LAGOON XING
HOUMA, LA 70360
Counselor (Mental Health)
144 VALHI LAGOON XING
HOUMA, LA 70360
Marriage & Family Therapist
144 VALHI LAGOON XING
HOUMA, LA 70360
Counselor (Professional)
144 VALHI LAGOON XING
HOUMA, LA 70360
Counselor (Professional)
144 VALHI LAGOON XING
HOUMA, LA 70360
Counselor
144 VALHI LAGOON XING
HOUMA, LA 70360
Counselor (Professional)
144 VALHI LAGOON XING
HOUMA, LA 70360
Massage Therapist
144 VALHI LAGOON XING
HOUMA, LA 70360

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780029645, enumerated as an "individual" on May 06, 2013.

The provider is located at 144 VALHI LAGOON XING HOUMA, LA 70360 and the phone number is (985) 262-1639.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: HMO Louisiana and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.

Shyam Mani is affiliated with: TERREBONNE GENERAL MEDICAL CENTER - PARISH and LEONARD J CHABERT MEDICAL CENTER.