Individual provider Active NPI

Jessymol V Manchery, NP-FAMILY

  • Family Nurse Practitioner
  • Jersey City, NJ
National Provider Identifier
1447323381
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00099300 Issued in NJ
Practice address
355 Grand St
Jersey City, NJ 07302-4321
Phone
(201) 915-2000
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00099300 NJ Primary

Addresses

Primary practice location

355 Grand St
Jersey City, NJ 07302-4321

Mailing address

577 Ludlow Ave
Cranford, NJ 07016-3231
Phone (908) 276-5745

Other names 1

  • Mrs. Jessymol V Manchery Professional name

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
I20080501000176 NJ Practitioner - Nurse Practitioner 5991884058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00099300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of New Jersey LLC Family CurrentSince Sep 5, 2006 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Aug 1, 2016 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Aug 1, 2016 Accepting new patients

Locations

471 Main St
Chatham, NJ 07928
Phone (973) 635-4636

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

4 Ryan Rd
Marlboro, NJ 07746
Phone (732) 431-8700

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447323381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 LUDLOW AVE",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070163231",
            "telephone_number": "908-276-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "201-915-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHERY",
        "first_name": "JESSYMOL",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "NP-FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00099300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSYMOL",
            "last_name": "MANCHERY",
            "middle_name": "V",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.