Individual provider Active NPI

Rachel Manez

  • Nurse Practitioner
  • Glen Ridge, NJ
National Provider Identifier
1902347370
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00918700 Issued in NJ
Practice address
123 Highland Ave
Glen Ridge, NJ 07028-1527
Phone
(973) 429-8800
NPI assigned
Mar 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00918700 NJ Primary

Addresses

Primary practice location

123 Highland Ave
Glen Ridge, NJ 07028-1527

Mailing address

123 Highland Ave
Glen Ridge, NJ 07028-1527
Phone (973) 429-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180213000259 NY Practitioner - Nurse Practitioner 3274893243 Reassigns benefits to 1 organization
I20200521000537 NJ Practitioner - Nurse Practitioner 3274893243

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Dec 23, 2017 Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 23, 2017 Accepting new patients

Locations

525 E 68th St
#585
New York, NY 10065
Phone (212) 746-2059

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": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1902347370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "973-429-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "973-429-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEZ",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00918700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

Verify at the official NPI Registry.