Manoj Puthiyathu

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

25MA09523700 Issued in NJ

Practice address

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Phone

(201) 967-4132

NPI assigned

Jun 24, 2009

Last updated

Jul 30, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bergen County Improvement AuthorityGroup PAC ID 9032104047, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center Psychiatry Provider Group

  • Psychiatry Physician
  • Paramus, NJ
  • NPI 1578641924
  Medicare reassignment Care Compare group NPD
• Bergen Psychiatric Care LLC

  • Child & Adolescent Psychiatry Physician
  • Ridgewood, NJ
  • NPI 1295255149
  Medicare reassignment NPD
• Prime Healthcare Services - St. Mary's Passaic, LLC

  dba St. Mary's Hospital

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1730508250
  Medicare reassignment NPD
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1952456295
  NPD
• Prime Healthcare Services - St. Mary's Passaic LLC

  dba St. Mary's Hospital

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1770901761
  NPD
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1689682999
  NPD (past)
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1770626236
  NPD (past)

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1649408956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LINDEN ST",
            "address_2": "APT C9",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHIYATHU",
        "first_name": "MANOJ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA09523700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatry Physician in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Child & Adolescent Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.