Active NPI
Manjula Chava, PA
- Physician Assistant
- Staten Island, NY
National Provider Identifier
1205231719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 018132-1
- Practice address
- 1534 Victory Blvd
Staten Island, NY 10314-3548 - Phone
- (718) 667-3577
- Fax
- (718) 351-7151
- NPI assigned
- Oct 27, 2014
- Last updated
- May 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 018132-1 | NY | Primary |
Addresses
Primary practice location
1534 Victory Blvd
Staten Island, NY 10314-3548
Mailing address
1534 Victory Blvd
Staten Island, NY 10314-3548
Phone (718) 667-3577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180906001650 | NY | Order and Referring Only - Physician Assistant | 7315297652 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018132 | NY | MD | Occupational Therapist |
| 018132-1 | NY | MD | Speech-Language Pathologist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- manjula.chava.p1@direct.rcnj.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1205231719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1534 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103143548",
"telephone_number": "718-667-3577",
"fax_number": "718-351-7151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1534 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103143548",
"telephone_number": "718-667-3577",
"fax_number": "718-351-7151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVA",
"first_name": "MANJULA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-27",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "018132-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.