NPIMap

Organization Active NPI

Manfredi Surgical & Orthopedic Co., Inc.

  • Prosthetic/Orthotic Supplier
  • Eatontown, NJ
National Provider Identifier
1215920012
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
45PO00001100 Issued in NJ
Legal business name
MANFREDI SURGICAL & ORTHOPEDIC CO., INC.
Doing business as
MANFREDI ORTHOTIC & PROSTHETIC AFFILATES
Practice address
749 Hope Rd
Suite C
Eatontown, NJ 07724-1432
Phone
(732) 380-0366
Fax
(732) 380-0245
NPI assigned
Aug 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Authorized official

Name
Mr. Robert C. Manfredi Jr., C.P.O., L.P.O.
Title
Owner
Phone
(732) 380-0366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 45PO00001100 NJ Primary

Addresses

Primary practice location

749 Hope Rd
Suite C
Eatontown, NJ 07724-1432

Mailing address

749 Hope Rd
Suite C
Eatontown, NJ 07724-1432
Phone (732) 380-0366

Other identifiers 1

IdentifierTypeStateIssuer
2641607MedicaidNJ

Other names 1

  • MANFREDI ORTHOTIC & PROSTHETIC AFFILATES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930051209 NJ DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 2466579354 Practice locations: Eatontown, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Manfredi Surgical & Orthopedic Co I749 Hope Rd, Eatontown, NJ 07724-1433(732) 380-0366 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Manfredi Surgical Ortho2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1215920012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 HOPE RD",
            "address_2": "SUITE C",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241432",
            "telephone_number": "732-380-0366",
            "fax_number": "732-380-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 HOPE RD",
            "address_2": "SUITE C",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241432",
            "telephone_number": "732-380-0366",
            "fax_number": "732-380-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANFREDI SURGICAL & ORTHOPEDIC CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "MANFREDI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-380-0366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "C.P.O., L.P.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NJ",
            "license": "45PO00001100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2641607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANFREDI ORTHOTIC & PROSTHETIC AFFILATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.