Manju Treesa Jose

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024188909 Issued in VA

Practice address

5436 Burlington CT
Williamsburg, VA 23188-7616

Phone

(757) 968-0936

NPI assigned

Dec 7, 2023

Last updated

Jan 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aevum BH VA LLCGroup PAC ID 3274067210, 35 clinicians

Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Legacy Care Aco LLCGroup PAC ID 3274996426, 36 clinicians

Legacy Care LLCGroup PAC ID 0042458200, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjose249758@direct.rivhs.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aevum BH VA LLC

  dba Aevum Behavioral Health

  • General Practice Physician
  • Richmond, VA
  • NPI 1225856008

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Legacy Care Aco LLC

  • Family Medicine Physician
  • Virginia BCH, VA
  • NPI 1538844857
  Medicare reassignment Care Compare group NPD
• Legacy Care LLC

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1902149776
  Medicare reassignment Care Compare group NPD
• Riverside Physician Services Inc

  dba Riverside Gastroenterology Specialists

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026
  Medicare reassignment Care Compare group NPD
• Hampton Newport News Community Services Board

  • Community/Behavioral Health Agency
  • Hampton, VA
  • NPI 1659424448
  Medicare reassignment NPD
• Supportive Care of Virginia LLC

  • Clinical Psychologist
  • Colonial Heights, VA
  • NPI 1801485354
  Medicare reassignment NPD
• Supportive Care of Maryland LLC

  • Psychologist
  • Riverdale, MD
  • NPI 1447802616

  DC

  Medicare reassignment NPD
• Riverside Physician Services Inc

  dba Riverside Gastroenterology Specialists Williamsburg

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services Inc

  dba Riverside Maternal Fetal Medicine Specialists

  • Maternal & Fetal Medicine Physician
  • Newport News, VA
  • NPI 1609897347
  NPD
• Aevum Behavioral Health VA LLC

  dba Aevum Behavioral Health

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1104650985

  Psychiatric/Mental Health

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Hospital Inc

  dba Riverside Regional Medical Center

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1023885373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HAMPTON NEWPORT NEWS CSB",
            "address_2": "600 MEDICAL DRIVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236667616",
            "telephone_number": "757-968-0936",
            "fax_number": "757-788-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5436 BURLINGTON CT",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231887616",
            "telephone_number": "757-968-0936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2244 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236662430",
            "country_code": "US",
            "telephone_number": "757-827-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSE",
        "first_name": "MANJU",
        "middle_name": "TREESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024188909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline B Jordan, CCC-SLP
• Kalisha Jordan, DDS
• Kendall Jordan
• Warren Horace Jordon, COTA/L
• Jose a. Erfe, M.D.
• Joseph Brown III, MD
• Joseph W Elrod Jr DDS LTD (Elrod & Dunham Dentistry Williamsburg)
• Shweta Nagendra Joshi, MD
• K and T Transport, LLC
• Kazi Imran Kabir, DO

• Psychiatric/Mental Health Nurse Practitioner in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.