Avani Manasa Kolla Patel, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

25MA12976500 Issued in NJ

Practice address

737 8TH St
Secaucus, NJ 07094-3019

Phone

(952) 992-9220

NPI assigned

Mar 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1699424101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 8TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 8TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943019",
            "telephone_number": "952-992-9220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 E Northfield Rd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070394532",
            "country_code": "US",
            "telephone_number": "973-736-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLA PATEL",
        "first_name": "AVANI",
        "middle_name": "MANASA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA12976500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "home",
            "affiliation": "N",
            "address_1": "737 8th St",
            "city": "Secaucus",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070943019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sonu Khatri
• Tamara Khmelnitsky, FNP
• Lucy Kim
• Kipnis Orthopaedic Rehab of Secaucus LLC
• Kipnis Physical Therapy and Sports Medicine
• Dani Korya, M.D.
• Poonam Kothari, MD
• Vinit Kothekar
• Maria A Labombarda, OD
• Jonathan Lang

• Dermatology Physician in Secaucus, NJ
• Providers in Secaucus, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.