Manhouly Phouthachack
NPI 1295965481ActiveIndividual· Nurse Practitioner, Family· Bristol, CT
Nurse Practitioner, Family with Mc Diagnostic of Connecticut, P.C. and 1 other group, practicing in Bristol, Connecticut. 82 Medicare patients in 2024, $8,765 paid; nearly all of their 82 Part D prescriptions were generic (94%).
Overview
| NPI | 1295965481 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 22, 2009 |
| Last updated in NPPES | May 16, 2025 |
| Certified by provider | May 16, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 004098 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (CT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 82 |
|---|---|
| Services billed | 169 across 17 procedure codes |
| Paid by Medicare | $8,765 |
Part D prescriptions in 2024
| Prescriptions (claims) | 82 · 84 30-day fills |
|---|---|
| Patients | 74 |
| Total drug cost | $601.55 |
| Generic share | 94% of claims |
Education and affiliations
| Graduation year | 2007 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical groups
- Mc Diagnostic of Connecticut, P.C.Glastonbury, CT · 67 clinicians
- Minuteclinic Primary Care Connecticut PLLCRocky Hill, CT · 7 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other family nurse practitioners in Bristol
- 1013507110
- 1376220442
- 1700463569
- 1871244723
- 1891546370
- 1265023071
- 1689370751
- 1912463662
- 1063700995
- 1184266967
- 1285490789
- 1366940298
All 40 family nurse practitioners in Bristol · All family nurse practitioners in Connecticut