Simone Alexander Manigault, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA08139400 Issued in NJ

Practice address

741 Broadway
Newark, NJ 07104-4309

Phone

(973) 483-1300

NPI assigned

Oct 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

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.

• Newark Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1740345693
  Medicare reassignment NPD
• Central Jersey Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Carteret, NJ
  • NPI 1932974250
  Medicare reassignment
• Central Jersey Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1932512092
  NPD
• Newark Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1366993586
  NPD
• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  NPD (past)
• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1417039132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300",
            "fax_number": "973-676-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088613396",
            "country_code": "US",
            "telephone_number": "732-376-9333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANIGAULT",
        "first_name": "SIMONE",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08139400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115045",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaydeep C Manek, MS, RPH
• Donna Mangione, CNM
• Bonita T. Mangura, M.D.
• Carolina Tsoi Mangura, M.D.
• Yesha Maniar
• Megan C Maniscalco, CRNA
• Melissa Elizabeth Maniscalco, DNP, FNP-BC
• Whilma Maniti, P.T.
• Nikita Sanjay Manjrekar, DO
• Mankind Care LLC

• Pediatrics Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.