SHORE SURGICAL PAVILION, LLC
NPI 1154622579
Clinic/Center - Ambulatory Surgical in Lakewood, NJ

NPI Status: Active since November 17, 2010

Contact Information

475 ROUTE 70
SUITE 202
LAKEWOOD, NJ
ZIP 08701
Phone: (732) 730-3939
Fax: (732) 730-9119

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 31D2027255
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 07-19-2027

About SHORE SURGICAL PAVILION, LLC

This page provides the complete NPI Profile along with additional information for Shore Surgical Pavilion, Llc, a provider established in Lakewood, New Jersey operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1154622579 assigned on November 2010. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Mr. Douglas Manganelli M.d. (Medical Director)

NPI
1154622579
Provider Name
SHORE SURGICAL PAVILION, LLC
Entity Type
Organization
Location Address
475 ROUTE 70 SUITE 202 LAKEWOOD, NJ 08701
Location Phone
(732) 730-3939
Location Fax
(732) 730-9119
Mailing Address
475 ROUTE 70 SUITE 202 LAKEWOOD, NJ 08701
Mailing Phone
(732) 730-3939
Mailing Fax
(732) 730-9119
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-17-2010
Last Update Date
11-19-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. DOUGLAS MANGANELLI M.D.

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(732) 730-3939

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 55 times for 32 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 89 times for 52 patients

Injection of anesthetic agent and/or steroid into other nerve or branch

This procedure involves injecting an anesthetic agent or steroid into a specific nerve or its branch. The goal is to relieve pain by reducing inflammation and numbing the area. It is commonly used for chronic pain management. The process is safe and usually quick.

This service was performed 30 times for 12 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 84 times for 49 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 129 times for 52 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 23 times for 22 patients

Injection of trigger points, 1-2 muscles

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

This service was performed 12 times for 12 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 28 times for 13 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 107 times for 64 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
31D2027255
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
July 20, 2025
Certificate Expiration Date
July 19, 2027
Laboratory Director
STACEY FRANZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Shore Surgical Pavilion, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1154622579, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
5
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 6 → 12 → 3 2 → 4 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 0 + 4 + 1 + 2 + 2 + 4 + 5 + 1 + 4 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1154622579.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Specialist
475 ROUTE 70, SUITE 103
LAKEWOOD, NJ 08701
Obstetrics & Gynecology
475 ROUTE 70, SUITE 101
LAKEWOOD, NJ 08701
Obstetrics & Gynecology
475 ROUTE 70, STE 101 OCEAN GYNECOLOGICAL & OBSTETRICAL ASSOC
LAKEWOOD, NJ 08701
Obstetrics & Gynecology
475 ROUTE 70
LAKEWOOD, NJ 08701
Internal Medicine (Gastroenterology)
475 ROUTE 70, SUITE 103
LAKEWOOD, NJ 08701
Advanced Practice Midwife
475 ROUTE 70
LAKEWOOD, NJ 08701
Internal Medicine (Gastroenterology)
475 ROUTE 70, SUITE 103
LAKEWOOD, NJ 08701

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154622579, enumerated as an "organization" on November 17, 2010.

The provider is located at 475 ROUTE 70 SUITE 202 LAKEWOOD, NJ 08701 and the phone number is (732) 730-3939.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.