Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jeremy Robert Man, MD

Individual provider Dermatology Physician · NPI 1104136381

Dr. Jeremy Robert Man, MD is a Dermatology in Hackensack, New Jersey. Qualified in 2004, 22 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
22
Licensed in
NJ
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

20 Prospect Ave Ste 702
Hackensack, NJ 07601-1974
Phone: (201) 441-9890
Fax: (201) 441-9893
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 25MA08756000 (NJ)

Record details

NPI number1104136381
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 20, 2010
Last updated in NPPESNovember 4, 2021
Certification dateNovember 4, 2021
Mailing address20 Prospect Ave Ste 702, Hackensack, NJ 07601-1974

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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