Organization Active NPI

Jasty & Manvar PC

  • Cardiovascular Disease Physician
  • Brooklyn, NY
National Provider Identifier
1578695995
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
141049 Issued in NY
Legal business name
JASTY & MANVAR PC
Practice address
6414 Bay Pkwy
Brooklyn, NY 11204-3929
Phone
(718) 234-2300
Fax
(718) 234-0098
NPI assigned
Mar 12, 2007
Last updated
Sep 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Buddhadev Manvar, M.D.NPI 1629061833
Title
President
Phone
(718) 234-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 215612 NY
Internal Medicine Physician 207R00000X 141049 NY
Internal Medicine Physician 207R00000X 139432 NY
Cardiovascular Disease Physician 207RC0000X 141049 NY Primary
Cardiovascular Disease Physician 207RC0000X 139342 NY
Nuclear Cardiology Physician 207UN0901X 139432 NY
Nuclear Cardiology Physician 207UN0901X 141049 NY
Vascular Surgery Physician 2086S0129X 141049 NY

Addresses

Primary practice location

6414 Bay Pkwy
Brooklyn, NY 11204-3929

Mailing address

6414 Bay Pkwy
Brooklyn, NY 11204-3929
Phone (718) 234-2300

Other identifiers 3

IdentifierTypeStateIssuer
00579740MedicaidNY
00709628MedicaidNY
02098548MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001453 NY Part B Supplier - Clinic/Group Practice 1951292416 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

6414 Bay Pkwy
Ste 1
Brooklyn, NY 11204
Phone (718) 234-2300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1578695995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6414 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112043929",
            "telephone_number": "718-234-2300",
            "fax_number": "718-234-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112043929",
            "telephone_number": "718-234-2300",
            "fax_number": "718-234-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASTY & MANVAR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "MANVAR",
        "authorized_official_first_name": "BUDDHADEV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-234-2300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "215612",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "141049",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "139432",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "141049",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "139342",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NY",
            "license": "139432",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NY",
            "license": "141049",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "141049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00579740",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00709628",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02098548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.