Organization Active NPI

Farag a Mankarios MD LLC

  • Internal Medicine Physician
  • Colts Neck, NJ
National Provider Identifier
1235639394
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07048000 Issued in NJ
Legal business name
FARAG A MANKARIOS MD LLC
Practice address
410 Route 34 Ste 216
Colts Neck, NJ 07722-2519
Phone
(732) 863-5515
NPI assigned
Feb 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Authorized official

Name
Mary Mankarios
Title
Administrator
Phone
(732) 863-5515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA07048000 NJ Primary

Addresses

Primary practice location

410 Route 34 Ste 216
Colts Neck, NJ 07722-2519

Mailing address

PO Box 32
Marlboro, NJ 07746-0032
Phone (732) 863-5515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180423000380 NJ Part B Supplier - Clinic/Group Practice 1254694417 Receives reassigned benefits from 1 practitioner
Practice locations: Colts Neck, NJ

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1042646Farag a Mankarios MD410 Route 34 Suite 216, Colts Neck, NJ 07722Certificate of waiverJul 4, 2027

National Provider Directory

National Provider Directory

Locations

410 State Route 34
Ste 216
Colts Neck, NJ 07722
Phone (732) 863-5515

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518652800000",
    "number": "1235639394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077460032",
            "telephone_number": "732-863-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 ROUTE 34 STE 216",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222519",
            "telephone_number": "732-863-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARAG A MANKARIOS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-15",
        "last_updated": "2018-02-15",
        "status": "A",
        "authorized_official_last_name": "MANKARIOS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-863-5515"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07048000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; 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.