Patricia Mankeh Manjong

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2267823 Issued in MA

Practice address

29 Read St
Lowell, MA 01850-2513

Phone

(978) 328-7709

NPI assigned

Apr 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Henry Kengong Ntoro LLCGroup PAC ID 9537420195, 2 clinicians

Bridgewell, IncGroup PAC ID 6507833985, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bridgewell, Inc

  • Community/Behavioral Health Agency
  • Lowell, MA
  • NPI 1033262860

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Henry Kengong Ntoro LLC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Lowell, MA
  • NPI 1831614692

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Bridgewell Counseling

  • Mental Health Counselor
  • Lowell, MA
  • NPI 1922316058

  Single Specialty

  NPD (past)

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

• Anna Jaques Hospital

  • General Acute Care Hospital
  • Newburyport, MA
  • NPI 1992779482
  Care Compare affiliation

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1316567563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 READ ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018502513",
            "telephone_number": "978-328-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 READ ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018502513",
            "telephone_number": "978-328-7709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Merrimack St Ste 441",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018521709",
            "country_code": "US",
            "telephone_number": "978-455-6798",
            "fax_number": "978-455-6576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANJONG",
        "first_name": "PATRICIA",
        "middle_name": "MANKEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2267823",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2267823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Socheata Mam
• Kelli Mandeville
• Tasha Lynn Mandeville, PMHNP-BC
• Maryam Mandsaurwala
• Nigar Manjanova
• Valerie Manning-Jones, RN
• Cynthia Lynn Manning, M.D.
• Lovetta Mansaray
• Tarina M Mansur, PA-C
• Chaitali B Manvi

• Psychiatric/Mental Health Nurse Practitioner in Lowell, MA
• Providers in Lowell, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.
• 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.