Individual provider Active NPI

Manisha T. Patel, M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1275553315
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
255583 Issued in NY
Practice address
30 Broad St
45TH Floor
New York, NY 10004-2304
Phone
(212) 530-0630
Fax
(415) 252-7176
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 209897 MA
Family Medicine Physician 207Q00000X MD072672L PA
Family Medicine Physician 207Q00000X 202102093 NC
Family Medicine Physician 207Q00000X 25MA08161500 NJ
Family Medicine Physician 207Q00000X 255583 NY Primary

Addresses

Primary practice location

30 Broad St
45TH Floor
New York, NY 10004-2304

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

200 Park At North Hills St Ste 100
Raleigh, NC 27609-2658
Phone (888) 663-6331

Other practice location 2

905 W Main St Ste B101
Durham, NC 27701-2054
Phone (888) 663-6331

Other identifiers 7

IdentifierTypeStateIssuer
413307OtherRI BLUE CHIP
J24034OtherMAMABC
AA59391OtherMAHPHC
209897OtherMATUFTS
0148725MedicaidMA
0237449OtherMACIGNA
000000033267OtherMABMC HEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110503000100 NY Practitioner - Family Practice 9537172804 Reassigns benefits to 2 organizations
I20210827002172 NC Practitioner - Family Practice 9537172804

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Embarcadero Ctr
Suite 1900
San Francisco, CA 94111-3723

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202102093NCMDFamily Medicine Physician
25MA08161500NJMDFamily Medicine Physician
MD072672LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Bridgewater Goddard Park Medical Associates, Inc. Past Accepting new patients

Locations

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

30 Broad St
Fl 45
New York, NY 10004
Phone (212) 530-0630

185 Broadway
#2
New York, NY 10007
Phone 8886636331 ext. 86791

30 Broad St
Fl 45
New York, NY 10004
Phone (212) 530-0630

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1275553315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST",
            "address_2": "45TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042304",
            "telephone_number": "212-530-0630",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Park At North Hills St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276092658",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 W Main St Ste B101",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277012054",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHA",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "209897",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD072672L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "202102093",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08161500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "255583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP",
            "identifier": "413307",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MABC",
            "identifier": "J24034",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA59391",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "209897",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148725",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0237449",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000033267",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.