Manu V Chakravarthy, MD PHD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

2006005275 Issued in MO

Practice address

1 RWJ Place
Meb 384
New Brunswick, NJ 08901

Phone

(732) 235-7749

Fax

(314) 747-8963

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1902847767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RWJ PLACE",
            "address_2": "MEB 384",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-235-7749",
            "fax_number": "314-747-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RWJ PLACE",
            "address_2": "MEB 384",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-235-7749",
            "fax_number": "314-747-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRAVARTHY",
        "first_name": "MANU",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2006005275",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA08631300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200871606",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0214370",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.