Individual provider Active NPI

Manisha Patel, M.D.

  • Neuroradiology Physician
  • Berkeley Heights, NJ
National Provider Identifier
1760744155
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
25MA11180100 Issued in NJ
Practice address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone
(908) 277-8673
Fax
(908) 790-6524
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD464019 PA
Diagnostic Radiology Physician 2085R0202X MD464019 PA
Student in an Organized Health Care Education/Training Program 390200000X MT202101 PA
Neuroradiology Physician 2085N0700X 25MA11180100 NJ Primary

Addresses

Primary practice location

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Mailing address

PO Box 3247
Evansville, IN 47731-3247
Phone (812) 471-1591

Other practice location 1

111 S 11th St
Jefferson University Hospitals
Philadelphia, PA 19107-4824
Phone (215) 955-6000

Other practice location 2

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, NY3 enrollments
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.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180606000033 PA Practitioner - Diagnostic Radiology 1355564006 Reassigns benefits to 1 organization
I20210922002236 NJ Practitioner - Diagnostic Radiology 1355564006 Reassigns benefits to 1 organization
I20230511001520 NY Practitioner - Interventional Radiology 1355564006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

14 W 14TH St
New York, NY 10011-7524
Phone (212) 390-0558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD464019PAMDNeuroradiology Physician
MT202101PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Aug 9, 2021 Accepting new patients
Southeast Radiology LTD Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 2, 2023 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 2, 2023 Accepting new patients
Summit Medical Group PA CurrentSince Aug 9, 2021 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

1345 Avenue of the Americas
Fl 8
New York, NY 10105
Phone (212) 913-0828

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

175 E Chester Pike
Ridley Park, PA 19078
Phone (610) 595-6000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: manisha.patel.2@2983.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1760744155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3247",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313247",
            "telephone_number": "812-471-1591",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-277-8673",
            "fax_number": "908-790-6524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_2": "Jefferson University Hospitals",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "19013",
            "country_code": "US",
            "telephone_number": "610-447-2500",
            "fax_number": "610-447-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD464019",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD464019",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT202101",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NJ",
            "license": "25MA11180100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.