Manhouly Phouthachack
NPI 1295965481 · Family Nurse Practitioner · Bristol, CT
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1295965481
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 004098 (CT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
16 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
109 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 43 | $83 |
| Detection Test By Immunoassay Technique for Severe Acute Respiratory Syndrome Coronavirus87426 | 27 | $34 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 24 | $103 |
| Detection Test By Nucleic Acid for Strep (streptococcus, Group A), Amplified Probe Technique87651 | 15 | $34 |
Typical Medicare-allowed amounts for these services range $34–$103 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Additional practice locations (1)
- 920 2nd Ave SSuite 400Minneapolis, MN 55402-3318Phone: (612) 225-1534
Registry dates
- Enumerated
- 2009-07-22
- Last updated
- 2025-05-16
- Certified
- 2025-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.