Individual provider Active NPI

Karen Elizabeth Manista, ATC

  • Other Specialist/Technologist
  • Summit, NJ
National Provider Identifier
1700813748
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
License
25MT00002800 Issued in NJ
Practice address
125 Kent Place Blvd
Summit, NJ 07901-4704
Phone
(908) 273-1494
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X 25MT00002800 NJ Primary

Addresses

Primary practice location

125 Kent Place Blvd
Summit, NJ 07901-4704

Mailing address

100 Seaview Ave
5-9
Monmouth Beach, NJ 07750-1256
Phone (732) 571-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MT00002800NJMDOther Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1700813748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SEAVIEW AVE",
            "address_2": "5-9",
            "city": "MONMOUTH BEACH",
            "state": "NJ",
            "postal_code": "077501256",
            "telephone_number": "732-571-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 KENT PLACE BLVD",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014704",
            "telephone_number": "908-273-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANISTA",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NJ",
            "license": "25MT00002800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.