Individual provider Active NPI

Paola Natali Reynoso- Manook, N.P.

  • Family Nurse Practitioner
  • Montclair, NJ
National Provider Identifier
1578010393
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341014 Issued in NY
Practice address
28 Valley Rd # 148
Montclair, NJ 07042-2709
Phone
(973) 559-4600
Fax
(855) 998-4358
NPI assigned
Sep 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 341014 NY Primary

Addresses

Primary practice location

28 Valley Rd # 148
Montclair, NJ 07042-2709

Mailing address

55 Broad St
21St Floor
New York, NY 10004-2501

Other practice location 1

55 Broad St
21st floor
New York, NY 10004-2501
Phone (347) 689-6821

Other names 1

  • Paola Natali Reynoso Former 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
I20250402000954 NJ Practitioner - Nurse Practitioner 6002339850 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
341014NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Medical Services of New Jersey LLC Current Accepting new patients
Harmony Medical Services of New Jersey LLC CurrentSince Mar 1, 2025 Accepting new patients
Urban Family Practice PC Family Past Accepting new patients

Locations

28 Valley Rd
Montclair, NJ 07042
Phone (908) 451-8519

Interoperability endpoints

  • Direct secure messaging: paola.reynoso-manook.1@32913.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1578010393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BROAD ST",
            "address_2": "21ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 VALLEY RD # 148",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422709",
            "telephone_number": "973-559-4600",
            "fax_number": "855-998-4358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Broad St",
            "address_2": "21st floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100042501",
            "country_code": "US",
            "telephone_number": "347-689-6821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOSO- MANOOK",
        "first_name": "PAOLA",
        "middle_name": "NATALI",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAOLA",
            "last_name": "REYNOSO",
            "middle_name": "NATALI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.