Individual provider Active NPI

Manjeet Kaur Achreja, MD

  • Family Medicine Physician
  • Seagrove, NC
National Provider Identifier
1659368108
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29458 Issued in NC
Practice address
614 N Broad St
Seagrove, NC 27341-8613
Phone
(336) 873-7248
Fax
(336) 873-7238
NPI assigned
Sep 30, 2005
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 29458 NC
Family Medicine Physician 207Q00000X 29458 NC Primary
General Practice Physician 208D00000X 29458 NC

Addresses

Primary practice location

614 N Broad St
Seagrove, NC 27341-8613

Mailing address

614 N Broad St
Seagrove, NC 27341-8613
Phone (336) 873-7248

Other identifiers 1

IdentifierTypeStateIssuer
343962AMedicaidNC

Other names 1

  • Dr. Manjeet Kaur Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080207000602 NC Practitioner - Family Practice 8820171218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 N Broad St
Seagrove, NC 27341-8613
Phone (336) 873-7248

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29458NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seagrove Medical Clinic, P.a. Family Medicine CurrentSince Aug 11, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

614 N Broad St
Seagrove, NC 27341
Phone (336) 873-4248

Interoperability endpoints

  • Direct secure messaging: machreja@591.securemail.prognocis.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Seagrove Medical ClinicSeagrove, NC, CCN 343962 Rural health clinic 5% Or Greater Direct Ownership Interest Sep 7, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1659368108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 N BROAD ST",
            "city": "SEAGROVE",
            "state": "NC",
            "postal_code": "273418613",
            "telephone_number": "336-873-7248",
            "fax_number": "336-873-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 N BROAD ST",
            "city": "SEAGROVE",
            "state": "NC",
            "postal_code": "273418613",
            "telephone_number": "336-873-7248",
            "fax_number": "336-873-7238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHREJA",
        "first_name": "MANJEET",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "29458",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "29458",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "29458",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343962A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANJEET",
            "last_name": "KAUR",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Seagrove, NC

Sources for this page

Verify at the official NPI Registry.