NPIMap

Individual provider Active NPI

Manoj M. Thakker, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Northfield, NJ
National Provider Identifier
1679550297
Registry record updated May 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
25MA08673200 Issued in NJ
Practice address
1500 Tilton Rd
Northfield, NJ 08225-1827
Phone
(609) 646-5200
Fax
(609) 646-9868
NPI assigned
Dec 23, 2005
Last updated
May 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 042-0011003 VT
Ophthalmology Physician 207W00000X MD00042397 WA
Ophthalmology Physician 207W00000X 25MA08673200 NJ
Ophthalmology Physician 207W00000X 237850 MA
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 25MA08673200 NJ Primary

Addresses

Primary practice location

1500 Tilton Rd
Northfield, NJ 08225-1827

Mailing address

1500 Tilton Rd
Northfield, NJ 08225-1827
Phone (609) 646-5200

Other identifiers 2

IdentifierTypeStateIssuer
0243833MedicaidNJ
1011768MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000520 NJ Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 3173517646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
Icahn School of Medicine at Mount Sinai, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cosmetic and Dermatologic Surgery Associates LLCGroup PAC ID 3971781402, 3 clinicians

Practice addresses (Care Compare)

719 N Beers St
Suite 2G
Holmdel, NJ 07733-1523
Phone (732) 739-3223

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08673200NJMDOphthalmology Physician
042-0011003VTMDOphthalmology Physician
MD00042397WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cosmetic and Dermatologic Surgery Associates LLC Ophthalmology CurrentSince Apr 17, 2011 Accepting new patients
Retinal & Ophthalmic Consultants, P.C. Ophthalmology CurrentSince Oct 1, 2010 Accepting new patients
Eye Care Associates, PC Ophthalmology PastSince Jan 1, 2007 Accepting new patients
South Suburban Ear, Nose & Throat Assoc Inc Past Accepting new patients
Eye Centers of America, LLC Ophthalmology Past Accepting new patients
Palisade Eye Associates,P.C. Ophthalmology PastSince Aug 24, 2009 Accepting new patients

Locations

719 N Beers St
Ste 2G
Holmdel, NJ 07733
Phone (732) 264-0086

1500 Tilton Rd
Northfield, NJ 08225
Phone (484) 434-2700

2466 E Chestnut Ave
Ste 3
Vineland, NJ 08361
Phone (856) 507-0020

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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 10

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462665600000",
    "number": "1679550297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 TILTON RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251827",
            "telephone_number": "609-646-5200",
            "fax_number": "609-646-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 TILTON RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251827",
            "telephone_number": "609-646-5200",
            "fax_number": "609-646-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKER",
        "first_name": "MANOJ",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2016-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VT",
            "license": "042-0011003",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00042397",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA08673200",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "237850",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA08673200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243833",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011768",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

Verify at the official NPI Registry.