Individual provider Active NPI

Manual A Fernandez, MD

  • Anesthesiology Physician
  • Edison, NJ
National Provider Identifier
1487619144
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MA35509 Issued in NJ
Practice address
205 May St
Suite 103
Edison, NJ 08837-3267
Phone
(732) 661-9075
NPI assigned
Apr 18, 2006
Last updated
Jul 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MA35509 NJ Primary

Addresses

Primary practice location

205 May St
Suite 103
Edison, NJ 08837-3267

Mailing address

PO Box 387
Fords, NJ 08863-0387
Phone (732) 826-4177

Other identifiers 1

IdentifierTypeStateIssuer
0432903MedicaidNJ

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
I20040116000378 NJ Practitioner - Anesthesiology 3173429875 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA35509NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
May Street Anesthesia Anesthesiology CurrentSince Oct 1, 2003 Accepting new patients
Gastroenterology Consultants, P.a. Past Accepting new patients
Rock Associates LLC Anesthesiology Past Accepting new patients

Locations

205 May St
Edison, NJ 08837
Phone (732) 661-9075

205 May St
Ste 103
Edison, NJ 08837
Phone (732) 525-0600

205 May St
Ste 201
Edison, NJ 08837
Phone (732) 661-9225

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, 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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1487619144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088630387",
            "telephone_number": "732-826-4177",
            "fax_number": "732-607-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAY ST",
            "address_2": "SUITE 103",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373267",
            "telephone_number": "732-661-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MANUAL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "MA35509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0432903",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.