NPIMap

Individual provider Active NPI

Anita Mannancheril, M.D.

  • Family Medicine Physician
  • Bridgewater, NJ
National Provider Identifier
1184962771
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10075100 Issued in NJ
Practice address
250 Route 28 Ste 100
Bridgewater, NJ 08807-1979
Phone
(908) 237-4135
Fax
(908) 237-4136
NPI assigned
Jan 17, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA10075100 NJ Primary

Addresses

Primary practice location

250 Route 28 Ste 100
Bridgewater, NJ 08807-1979

Mailing address

250 Route 28
Suite 100
Bridgewater, NJ 08807
Phone (908) 237-4135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, GA, NM4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20160224000925 NY Practitioner - Family Practice 3173828431 Reassigns benefits to 1 organization
I20180508001079 NJ Practitioner - Family Practice 3173828431 Reassigns benefits to 2 organizations
I20211028000136 GA Practitioner - Family Practice 3173828431
I20220322003113 NM Practitioner - Family Practice 3173828431

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

714 Route 10 W
Amg Primary Care at Randolph
Randolph, NJ 07869-2058
Phone (973) 891-1213

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10075100NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hunterdon Primary Care PC Family Medicine CurrentSince Mar 12, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Jan 12, 2017 Accepting new patients
Hunterdon Primary Care, PC Family Medicine CurrentSince Mar 12, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Jan 12, 2017 Accepting new patients
Hunterdon Primary Care PC Family Medicine Current Accepting new patients
Practice Associates Medical Group Family Medicine CurrentSince Jun 17, 2019 Accepting new patients
Marcus Zachary, D.O., P.C. Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7111 N Fresno St
Ste 200
Fresno, CA 93720
Phone (415) 353-6817

250 Route 28
Ste 100
Bridgewater, NJ 08807
Phone (908) 235-4135

2100 Wescott Dr
Flemington, NJ 08822
Phone (908) 237-5420

215 State Route 31
#116
Flemington, NJ 08822

3 Minneakoning Rd
Flemington, NJ 08822
Phone (908) 284-1125

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

714 State Route 10
Randolph, NJ 07869
Phone (973) 366-8338

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: anita.mannancheril.1@24719.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184962771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 ROUTE 28",
            "address_2": "SUITE 100",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "08807",
            "telephone_number": "908-237-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ROUTE 28 STE 100",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071979",
            "telephone_number": "908-237-4135",
            "fax_number": "908-237-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNANCHERIL",
        "first_name": "ANITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10075100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.