Individual provider Active NPI

Manuel Sanchez, MD

  • Psychiatry Physician
  • Newark, NJ
National Provider Identifier
1407828999
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MA62336 Issued in NJ
Practice address
183 S Orange Ave
Newark, NJ 07103-2757
Phone
(973) 972-8417
Fax
(973) 972-7173
NPI assigned
Feb 7, 2006
Last updated
Dec 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MA62336 NJ Primary

Addresses

Primary practice location

183 S Orange Ave
Newark, NJ 07103-2757

Mailing address

1028 Coolidge Rd
Elizabeth, NJ 07208-3625
Phone (973) 972-8417

Other identifiers 1

IdentifierTypeStateIssuer
7440804MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050113000902 NJ Practitioner - Psychiatry 0941259204 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA62336NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Co Board of Chosen Freehold Admin CurrentSince Sep 18, 2017 Accepting new patients
Rutgers Health - Behavioral Health Psychiatry CurrentSince Jan 25, 2016 Accepting new patients
Rutgers Health - Behavioral Health Psychiatry Current Accepting new patients
Smith Center for Infectious Diseases and Urban Health, P.a. PastSince Apr 12, 2010 Accepting new patients
Seacrest Medical Associates, P.a. Psychiatry Past Accepting new patients

Locations

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0480

671 Hoes Ln W
Rm D3381
Piscataway, NJ 08854
Phone (732) 235-3289

595 County Ave
Secaucus, NJ 07094
Phone (201) 369-5252

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1407828999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 COOLIDGE RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083625",
            "telephone_number": "973-972-8417",
            "fax_number": "973-972-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-8417",
            "fax_number": "973-972-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA62336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.