Individual provider Active NPI

Daniel D Manzi, M.D.

  • Gastroenterology Physician
  • Verona, NJ
National Provider Identifier
1487636957
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA03690300 Issued in NJ
Practice address
799 Bloomfield Ave Ste 102
Verona, NJ 07044-1301
Phone
(973) 433-7600
Fax
(973) 433-7462
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25MA03690300 NJ Primary

Addresses

Primary practice location

799 Bloomfield Ave Ste 102
Verona, NJ 07044-1301

Mailing address

799 Bloomfield Ave Ste 102
Verona, NJ 07044-1301
Phone (973) 433-7600

Other identifiers 1

IdentifierTypeStateIssuer
2095700MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03690300NJMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1487636957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 BLOOMFIELD AVE STE 102",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441301",
            "telephone_number": "973-433-7600",
            "fax_number": "973-433-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 BLOOMFIELD AVE STE 102",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441301",
            "telephone_number": "973-433-7600",
            "fax_number": "973-433-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZI",
        "first_name": "DANIEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA03690300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2095700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.