Kirsten L Manzo, ACNPC-AG
Individual provider Active NPI Adult Health Nurse Practitioner · Paterson, NJ
NPI 1114685013 · NPPES record last updated Sep 30, 2024
Key facts
- NPI
- 1114685013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 26NJ01243100 (NJ)
- Practice address
- 703 Main St
Paterson, NJ 07503-2621 - Phone
- (973) 754-2000
- NPI assigned
- Dec 8, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Josephs Medical Group PC
St Josephs Physicians Healthcare Group Inc
Practice addresses (Care Compare)
703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331
999 McBride Ave
Suite B204
Woodland Park, NJ 07424-2563
Phone (973) 754-2052
Hospital & facility affiliations
- St Joseph'S University Medical Center Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220608000938 | NJ | Practitioner - Nurse Practitioner | 7810375557 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Josephs Physicians Healthcare Group Inc | Current |
Accepting new patients | |
| St. Joseph'S Healthcare, Inc. | Current |
Accepting new patients | |
| St Josephs Medical Group PC | Current |
Accepting new patients |
Locations
703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240
703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331
703 Main St
Paterson, NJ 07503
Phone (973) 754-2240
225 Minnisink Rd
Fl 3
Totowa, NJ 07512
Phone (862) 657-3150
999 McBride Ave
Ste 204
Woodland Park, NJ 07424
999 McBride Ave
#B
Woodland Park, NJ 07424
Phone (973) 256-5667
999 McBride Ave
Ste B204
Woodland Park, NJ 07424
Phone (973) 256-5667
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 26NJ01243100 | NJ | |
| Adult Health Nurse Practitioner | 363LA2200X | 26NJ01243100 | NJ | Yes |
Addresses
Primary practice location
703 Main St
Paterson, NJ 07503-2621
Mailing address
703 Main St
Paterson, NJ 07503-2621
Other practice location 1
999 McBride Ave # B
Woodland Park, NJ 07424-2570
Phone (973) 256-5667
Other providers in Paterson, NJ
- Alfonso Mannisi
- Ragul Manoharan
- Sophia A Manoussos
- Shana T Manradge
- Antoine Mansourati
- Asad Manzoor
- Bilal Maqbool
- Marcela C. Marani-Dicovskiy
- Mario V Marasovic
- Ashley A Marchese-Fiallos
All providers in Paterson, NJ · Adult Health Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.