Individual provider Active NPI

Jancy Manoj

  • Gerontology Nurse Practitioner
  • Langhorne, PA
National Provider Identifier
1871142406
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP020204 Issued in PA
Practice address
100 N Buckstown Rd Ste E206
Langhorne, PA 19047-1815
Phone
(215) 741-1963
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP020204 PA Primary

Addresses

Primary practice location

100 N Buckstown Rd Ste E206
Langhorne, PA 19047-1815

Mailing address

813 Rennard St
Philadelphia, PA 19116-2917
Phone (267) 684-9627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191023000673 PA Practitioner - Nurse Practitioner 6103158241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP020204PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Long Term Medical Care of Pennsylvania PLLC Gerontology CurrentSince Jan 1, 2023 Accepting new patients
Comprehensive Care Medical Associates P C CurrentSince Sep 15, 2019 Accepting new patients

Locations

2507 Chestnut St
Chester, PA 19013
Phone (610) 872-5373

2595 Interstate Dr
Ste 103
Harrisburg, PA 17110
Phone (386) 672-4222

100 N Buckstown Rd
Ste E206
Langhorne, PA 19047
Phone (215) 741-1963

1104 Welsh Rd
Philadelphia, PA 19115
Phone (215) 676-7191

800 W Miner St
West Chester, PA 19382
Phone (484) 920-6200

Organizations & group practices 2

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": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1871142406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 RENNARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162917",
            "telephone_number": "267-684-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BUCKSTOWN RD STE E206",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471815",
            "telephone_number": "215-741-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOJ",
        "first_name": "JANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP020204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.