Individual provider Active NPI

Manesi Glorivi Mendez, CPNP, RN, BSN

  • Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1730531088
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15360200 Issued in NJ
Practice address
155 Polifly Rd Ste 102
Hackensack, NJ 07601-1771
Phone
(551) 996-8840
Fax
(201) 441-9949
NPI assigned
Jul 11, 2016
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 26NJ15360200 NJ Primary
Pediatric Nurse Practitioner 363LP0200X F382735-1 NY
Registered Nurse 163W00000X 706473-1 NY

Addresses

Primary practice location

155 Polifly Rd Ste 102
Hackensack, NJ 07601-1771

Mailing address

400 Fort Washington Ave Apt 1C
New York, NY 10033-6837
Phone (212) 923-8500

Other practice location 1

4008 Forley St
Elmhurst, NY 11373-1427
Phone (718) 446-0270

Other practice location 2

400 Fort Washington Ave Apt 1C
New York, NY 10033
Phone (212) 923-8500

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
I20251021001980 NJ Practitioner - Nurse Practitioner 1951899103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

331 Newman Springs Rd
Red Bank, NJ 07701-5688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
706473-1NYMDRegistered Nurse
26NJ15360200NJMDNurse Practitioner
F382735-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Complex Care PC CurrentSince Oct 8, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC PastSince Oct 5, 2025 Accepting new patients
Dap Medical Care PC Pediatrics Past Accepting new patients
Happy Kids Pediatrics PLLC PastSince Sep 1, 2024 Accepting new patients

Locations

155 Polifly Rd
Ste 102
Hackensack, NJ 07601
Phone (551) 996-8840

516 Lawrie St
Ste 1
Perth Amboy, NJ 08861

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1730531088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FORT WASHINGTON AVE APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336837",
            "telephone_number": "212-923-8500",
            "fax_number": "212-923-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 POLIFLY RD STE 102",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011771",
            "telephone_number": "551-996-8840",
            "fax_number": "201-441-9949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4008 Forley St",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731427",
            "country_code": "US",
            "telephone_number": "718-446-0270",
            "fax_number": "718-446-5939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Fort Washington Ave Apt 1C",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10033",
            "country_code": "US",
            "telephone_number": "212-923-8500",
            "fax_number": "212-923-6718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "MANESI",
        "middle_name": "GLORIVI",
        "credential": "CPNP, RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15360200",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382735-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "706473-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.