Organization Active NPI

Garden State Internists LLC

  • Internal Medicine Physician
  • Freehold, NJ
National Provider Identifier
1790448850
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GARDEN STATE INTERNISTS LLC
Doing business as
Garden State Internists LLC
Practice address
16 Thoreau Dr
Freehold, NJ 07728-4666
Phone
(732) 761-0221
Fax
(732) 780-1886
NPI assigned
Oct 15, 2021
Last updated
Mar 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Authorized official

Name
Manish SainiNPI 1962478776
Title
Owner
Phone
(732) 761-0221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

16 Thoreau Dr
Freehold, NJ 07728-4666

Mailing address

16 Thoreau Dr
Freehold, NJ 07728-4666
Phone (732) 761-0221

Other names 1

  • Garden State Internists LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220617000058 NJ Part B Supplier - Clinic/Group Practice 6709265051 Receives reassigned benefits from 9 practitioners
Practice locations: Toms River, NJ; Lanoka Harbor, NJ; Freehold, NJ; Brick, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0942192Garden State Internists LLC16 Thoreau Drive, Freehold, NJ 07728Certificate of waiverMar 8, 2028

National Provider Directory

National Provider Directory

Locations

16 Thoreau Dr
Freehold, NJ 07728
Phone (732) 597-0596

411 Route 9
Ste 6
Lanoka Harbor, NJ 08734
Phone (609) 971-1711

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1790448850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 THOREAU DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077284666",
            "telephone_number": "732-761-0221",
            "fax_number": "732-780-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 THOREAU DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077284666",
            "telephone_number": "732-761-0221",
            "fax_number": "732-780-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE INTERNISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-15",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "SAINI",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-761-0221"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden State Internists LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Garden State Internists LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.