Individual provider Active NPI

Melissa Elizabeth Maniscalco, DNP, FNP-BC

  • Family Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1669987350
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342420 Issued in NY
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(973) 926-7772
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 26NJ00791000 NJ
Nurse Practitioner 363L00000X 26NO12001900 NJ
Family Nurse Practitioner 363LF0000X 342420 NY Primary

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

336 Dogwood Dr
Union, NJ 07083-7817
Phone (908) 851-8669

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
I20180423000141 NJ Practitioner - Nurse Practitioner 5496018657 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NO12001900NJMDNurse Practitioner
342420NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HMH Hospitals Corporation CurrentSince Mar 1, 2022 Accepting new patients
Community Hospital Group Inc Current Accepting new patients
HMH Hospitals Corporation CurrentSince Mar 1, 2022 Accepting new patients
Community Hospital Group, Inc CurrentSince Oct 21, 2021 Accepting new patients
Nbimc Department of Cardio-Thoracic CurrentSince Apr 13, 2022 Accepting new patients
Community Hospital Group, Inc. CurrentSince Oct 21, 2021 Accepting new patients
Robert Wood Johnson Medical Associates Past Accepting new patients
Community Hospital Group, Inc Past Accepting new patients

Locations

65 James St
Lot G
Edison, NJ 08820
Phone (732) 321-7487

65 James St
Edison, NJ 08820
Phone (732) 321-7010

201 Lyons Ave
#L5
Newark, NJ 07112
Phone (973) 926-7161

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

Organizations & group practices 8

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": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1669987350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 DOGWOOD DR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837817",
            "telephone_number": "908-851-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANISCALCO",
        "first_name": "MELISSA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00791000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NO12001900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.