COASTAL BACK AND PAIN INSTITUTE (NPI# 1407212905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407212905 |
| Entity Type | Organization |
| Organization Name | COASTAL BACK AND PAIN INSTITUTE |
| Practice Address |
459 Jack Martin Blvd Brick NJ 08724-7724 |
| Mailing Address |
Po Box 297 Manasquan NJ 08736-0297 |
| Practice Telephone | 7327477077 |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |
| Authorized Official Name | DOUGLAS MANGANELLI (OWNER) |
| Authorized Official Telephone | 7327477077 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
459 JACK MARTIN BLVD |
| City | BRICK |
| State | NJ |
| Zip Code | 08724-7724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689665358 | James Aloysius Clarke | Family Medicine | 459 Jack Martin Blvd, Suite 1, Brick, NJ 08724-7724 | 2005-11-02 |
| 1275977555 | Harshil Patel | Internal Medicine | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2013-04-17 |
| 1740471580 | Ninfa A Alcasid | Internal Medicine | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2007-08-07 |
| 1649496043 | Theodore B Lygas Md F A C S Pa | Surgery | 459 Jack Martin Blvd, Suite 5a, Brick, NJ 08724-7724 | 2007-04-17 |
| 1528117207 | Theodore B. Lygas | Surgery | 459 Jack Martin Blvd, Suite 5a, Brick, NJ 08724 | 2007-01-10 |
| 1730254053 | John Michael Pellegrino | Surgery | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2006-11-21 |
| 1073619318 | Andrew L. Simon M.d., F.a.c.s, P.a. | Urology | 459 Jack Martin Blvd, Suite 3, Brick, NJ 08724-7724 | 2006-09-15 |
| 1508807082 | Virendra Patel | Internal Medicine | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2006-06-08 |
| 1992767388 | Andrew L. Simon | Urology | 459 Jack Martin Blvd, Suite 3, Brick, NJ 08724-7724 | 2006-04-03 |
| 1528048055 | Hojun Yoo | Internal Medicine | 459 Jack Martin Blvd, Ste 4, Brick, NJ 08724-7724 | 2006-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386498 | Mark Malak | Pharmacist | 668 New Jersey Ave # 70, Brick, NJ 08724 | 2020-11-08 |
| 1699381681 | Kimberly Granai | Nurse Practitioner | 1617 Nj-88, Brick Township, NJ 08724 | 2020-09-16 |
| 1407461346 | Marina N Samuel | Pharmacist | 1890 Rt 88, Brick, NJ 08724 | 2020-09-08 |
| 1255974440 | Diana Rachel Williamson | Pharmacy Technician | 1610 Rt. 88 West, Suite 103, Brick, NJ 08724 | 2019-10-21 |
| 1710536842 | Stephanie Ann Papa | Nurse Practitioner | 2125 Nj 88, Brick, NJ 08724 | 2019-09-11 |
| 1417504515 | Susan B Anthony | Physical Therapist | 676 Overlook Ct, Brick, NJ 08724 | 2019-08-22 |
| 1831688076 | Jennifer S Cashin | Social Worker | 1500 Nj-88, Brick, NJ 08724 | 2018-05-03 |
| 1528555315 | James Kish Pt | Physical Therapist | 602 Yellowbrick Rd, Brick, NJ 08724 | 2018-04-17 |
| 1396262200 | Michael Stephen Zito-govert | Nurse Practitioner | 1640 Route 88 West, Suite 203, Brick, NJ 08724 | 2017-08-23 |
| 1083140420 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Route 70 East, Brick, NJ 08724 | 2017-05-04 |
| Find all providers in zip 08724 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750914776 | Center for Regenerative Therapy and Pain Management | Anesthesiology | 459 Jack Martin Blvd Ste 4, Brick, NJ 08724-7724 | 2020-02-18 |
| 1477942423 | Morris Anesthesia Group, Pa | Anesthesiology | 495 Jack Martin Blvd, Brick, NJ 08724-7778 | 2015-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517044 | Excellence Medical Care, PC | Anesthesiology | 110 S Grove St Fl 2, East Orange, NJ 07018-4102 | 2020-10-28 |
| 1851998488 | Kenneth Paul Michelette | Anesthesiology | 72 W Jimmie Leeds Rd Ste 2500, Galloway, NJ 08205-9413 | 2020-10-06 |
| 1407462815 | Optimal Pain & Spine | Anesthesiology | 757 Route 202/206 Ste 104, Bridgewater, NJ 08807-1763 | 2020-09-21 |
| 1457986119 | Windsor Management LLC Michael Ole Fridman Sole Mbr. | Anesthesiology | 831 Main Ave Ste 5831, Passaic, NJ 07055-8400 | 2020-03-03 |
| 1083251375 | Joshua Persaud Md LLC | Anesthesiology | 2 Pine Meadow Ct, E Brunswick, NJ 08816 | 2019-12-05 |
| 1649816976 | Elizabeth Pavlovsky | Anesthesiology | 666 Plainsboro Rd Ste D, Plainsboro, NJ 08536-3030 | 2019-11-21 |
| 1265991772 | Interventional Spine and Surgery Group, LLC | Anesthesiology | 8901 Kennedy Blvd Fl 1, North Bergen, NJ 07047-5344 | 2019-03-14 |
| 1477017929 | Mountainside Pain Management PC | Anesthesiology | 185 Fairfield Ave Ste 2a, West Caldwell, NJ 07006-6417 | 2019-01-29 |
| 1043786346 | Neurosure | Anesthesiology | 326a 6th St, Saddle Brook, NJ 07663-6306 | 2018-10-15 |
| 1457842429 | Gout Institute of America | Anesthesiology | 727 Joralemon St., Belleville, NJ 07109 | 2018-05-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.