Manish Pravin Khetani, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA08344200 Issued in NJ

Practice address

55-77 Schanck Rd Ste B-13
Freehold, NJ 07728-2964

Phone

(732) 612-8485

NPI assigned

Nov 8, 2007

Last updated

Feb 22, 2022By the provider in NPPES

Sex

Male

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 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

Specialty

Internal MedicineAlso: Anesthesiology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: manish.khetani.1@23093.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/23093/brand/1/csg/1/fhir/r4

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.

• K Medical Associates PC

  • Internal Medicine Physician
  • Freehold, NJ
  • NPI 1720669088

  Single Specialty

  Medicare reassignment NPD Authorized official
• New Jersey Healthcare Specialists PC

  • Anesthesiology Physician
  • Hackensack, NJ
  • NPI 1174585780

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• HMH Hospitals Corporation

  dba JFK University Medical Center

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1447430244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TURNBERRY DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077269315",
            "telephone_number": "732-446-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55-77 SCHANCK RD STE B-13",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282964",
            "telephone_number": "732-612-8485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Butler Ave",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254059990",
            "country_code": "US",
            "telephone_number": "304-263-0811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHETANI",
        "first_name": "MANISH",
        "middle_name": "PRAVIN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08344200",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08344200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Marie Keville, PA-C
• Shameen Khan, D.O.
• Tahera Mishal Khan, OD
• Zeeshan Khan, M.D.
• Amit S Kharod, MD
• Kids Dental of NJ
• Sara Kiernan, APN
• Rachel M Kilpatrick, MSN, RN
• Miah Kim, DO
• Robert Gisub Kim, MD

• Internal Medicine Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.