Individual provider Active NPI

Kereme Manners, M.D.

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1619314374
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
285595 Issued in NY
Practice address
3011 Boston Rd
Bronx, NY 10469-4002
Phone
(718) 547-6111
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 285595 NY Primary

Addresses

Primary practice location

3011 Boston Rd
Bronx, NY 10469-4002

Mailing address

3011 Boston Rd
Bronx, NY 10469-4002
Phone (718) 547-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160902001580 NY Practitioner - Family Practice 4789970591 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285595NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 11, 2016 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 9, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Aug 11, 2016 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 9, 2021 Accepting new patients

Locations

3011 Boston Rd
Bronx, NY 10469
Phone (718) 547-6111

111 E 210th St
Bronx, NY 10467

1225 Gerard Ave
Bronx, NY 10452
Phone (718) 960-2777

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

2094 Pitkin Ave
Brooklyn, NY 11207
Phone (718) 240-0400

50 Water St
Fl 3
New York, NY 10004

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

227 Madison St
New York, NY 10002
Phone (212) 238-7000

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: kmanners846813@nychhc.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1619314374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104694002",
            "telephone_number": "718-547-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104694002",
            "telephone_number": "718-547-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNERS",
        "first_name": "KEREME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "285595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.