Individual provider Active NPI

Tyler Anthony Manlangit, PA-C

  • Surgical Physician Assistant
  • Glen Rock, NJ
National Provider Identifier
1407651383
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00915200 Issued in NJ
Practice address
85 Harristown Rd
Glen Rock, NJ 07452-3329
Phone
(844) 366-8800
NPI assigned
Feb 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 25MP00915200 NJ Primary

Addresses

Primary practice location

85 Harristown Rd
Glen Rock, NJ 07452-3329

Mailing address

85 Harristown Rd
Glen Rock, NJ 07452-3329
Phone (844) 366-8800

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260312003933 NJ Practitioner - Physician Assistant 4385127810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

57 Route 46
Suite 212
Hackettstown, NJ 07840

57 Route 46
Suite 212
Hackettstown, NJ 07840-2695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00915200NJMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Radiology Group of New Jersey, LLC Single Specialty CurrentSince Jan 31, 2026 Accepting new patients

Locations

278 Route 10
Succasunna, NJ 07876
Phone (624) 775-2888

Organizations & group practices 1

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": "1739577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1407651383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523329",
            "telephone_number": "844-366-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523329",
            "telephone_number": "844-366-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLANGIT",
        "first_name": "TYLER",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-15",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00915200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

Verify at the official NPI Registry.