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MISTY MANUEL
NPI 1811536378
Nurse Practitioner - Primary Care in Troy, OH

Active since January 02, 2020PECOS EnrolledAccepts Medicare Assignment
90.54/100
CMS Quality Rating
998 S DORSET RD STE 301, TROY, OH 45373(937) 339-9865 Get Directions Write a Review

NPPES record last updated: January 2, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Misty Manuel NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISTY MANUEL (NPI 1811536378) is an individual primary care provider in Troy, Ohio, licensed in Ohio (APRN.CNP.026127) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS, is affiliated with Upper Valley Medical Center, and is a graduate of University Of Cincinnati College Of Medicine (2019).

NPPES Registry Identity

NPI1811536378
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameMISTY MANUEL
Location Address998 S DORSET RD STE 301Troy, OH 45373-4748
Mailing Address998 S Dorset Rd Ste 301Troy, OH 45373-4748 · (937) 339-9865
Phone(937) 339-9865
Sole ProprietorYes
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2019
Enumeration DateJanuary 2, 2020
✔ NPI 1811536378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in OH · APRN.CNP.026127
998 S DORSET RD STE 301, Troy, OH 45373
Open in Google Maps ↗

Other Identifiers 1

OtherAPRN.CNP.026127OH · Aprn License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Misty Manuel is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991132607
PECOS Enrollment IDI20200218003128
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
412 services208 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
125 services125 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
95 services73 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
20 services16 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
14 services14 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Upper Valley Medical Center

Acute Care Hospitals · Troy, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360174
Location3130 North County Road 25ATroy, OH 45373 · Miami County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45373 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.54/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.73
Promoting Interoperability100
Improvement Activities40
Cost87.75

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers19 claims38 services$5.53 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers16 claims16 services$67.47 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$214.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT WELLS
Nurse Practitioner
998 S DORSET RD STE 301
TROY, OH 45373
Miami County (937) 339-9865
LEELMOHAN RAVIKUMAR M.D.,
Family Medicine
998 S DORSET RD STE 301
TROY, OH 45373
Miami County (937) 339-9865

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Misty Manuel's NPI number?

The NPI number for Misty Manuel is 1811536378. It was assigned to this individual provider in the NPPES registry on January 2, 2020.

Where is Misty Manuel located?

Misty Manuel practices at 998 S Dorset Rd Ste 301, Troy, OH 45373. The listed phone number is (937) 339-9865.

What is Misty Manuel's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Misty Manuel enrolled in Medicare?

Yes. Misty Manuel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Misty Manuel accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and MedMutual list Misty Manuel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Misty Manuel affiliated with any hospitals?

According to CMS data, Misty Manuel is affiliated with Upper Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Misty Manuel was last updated on January 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.