Individual provider Active NPI

Melanie Lynn Manger, FNP-C

  • Family Nurse Practitioner
  • Secaucus, NJ
National Provider Identifier
1629616404
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00998400 Issued in NJ
Practice address
1 Harmon PLZ
Secaucus, NJ 07094-2803
Phone
(551) 257-7611
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00998400 NJ
Family Medicine Physician 207Q00000X 26NJ00998400 NJ
Family Nurse Practitioner 363LF0000X 26NJ00998400 NJ Primary

Addresses

Primary practice location

1 Harmon PLZ
Secaucus, NJ 07094-2803

Mailing address

1 Harmon PLZ
Secaucus, NJ 07094-2803
Phone (551) 257-7611

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
I20200319002136 NJ Practitioner - Nurse Practitioner 3577991835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00998400NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Mar 1, 2020 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Mar 1, 2020 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Riverside Medical Group Nurse Practitioner PastSince Dec 15, 2019 Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

Interoperability endpoints

  • Direct secure messaging: melanie.manger.1@17698.direct.athenahealth.com

Organizations & group practices 4

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1629616404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARMON PLZ",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942803",
            "telephone_number": "551-257-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARMON PLZ",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942803",
            "telephone_number": "551-257-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGER",
        "first_name": "MELANIE",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00998400",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ00998400",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00998400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

Verify at the official NPI Registry.