Look up the most recent NPI and PECOS records

Manasi Revankar

Family Medicine

Allopathic & Osteopathic Physicians

185 Roseberry St, Phillipsburg, NJ 08865-1690

PECOS Enrollment

Based on the most recent information from CMS, provider Manasi Revankar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1619127024
Provider Type
Individual
Full Name
Revankar, Manasi
Credential
D.O.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
9/22/2008
Last Updated
9/2/2016

Contact Information

Practice Location

185 Roseberry St, Phillipsburg, NJ 08865-1690

(484) 526-6643

(484) 526-4658

Mailing Location

801 Ostrum St, St. Luke'S Enrollment Center, Bethlehem, PA 18015

(484) 526-8046

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 25MB09074300 New Jersey
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 262304 New York

Manasi Revankar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Bautista, Lucien S

Colasacco, Abigail

Warren Health Care Alliance Pc

Charles R Grubb Do Pc

Amazing Grace Medical Center Llc

Germaine, Jude

Lantin, Angela Therese

Veeraraghavan, Nandhini

Thomas, Taryn

Gilkey, Edward Alan