Individual provider Active NPI

Manjula Bathini, D.O.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Madison, NJ
National Provider Identifier
1508011719
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
25MB07831100 Issued in NJ
Practice address
300 Madison Ave
Suite 201
Madison, NJ 07940-1868
Phone
(973) 822-2772
Fax
(973) 822-2773
NPI assigned
Dec 2, 2008
Last updated
Dec 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MB07831100 NJ
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 25MB07831100 NJ Primary

Addresses

Primary practice location

300 Madison Ave
Suite 201
Madison, NJ 07940-1868

Mailing address

300 Madison Ave
Suite 201
Madison, NJ 07940-1868
Phone (973) 822-2772

Other identifiers 1

IdentifierTypeStateIssuer
263944134OtherNJHORIZON

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
I20110328000717 NJ Practitioner - Sleep MedicinePractitioner - Neurology 6406039528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB07831100NJMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Sleep Management, LLC Past Accepting new patients
Medical Associates of Englewood, PC PastSince Jul 30, 2016 Accepting new patients

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": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1508011719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MADISON AVE",
            "address_2": "SUITE 201",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401868",
            "telephone_number": "973-822-2772",
            "fax_number": "973-822-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MADISON AVE",
            "address_2": "SUITE 201",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401868",
            "telephone_number": "973-822-2772",
            "fax_number": "973-822-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATHINI",
        "first_name": "MANJULA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MB07831100",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NJ",
            "license": "25MB07831100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "263944134",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, NJ

Sources for this page

Verify at the official NPI Registry.