Active NPI
Mandy Elizabeth Duman, DPT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1093278228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 3020 Childrens Way # Mc5068
San Diego, CA 92123 - Phone
- (858) 966-5829
- NPI assigned
- Apr 14, 2019
- Last updated
- May 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary | |
| Orthopedic Physical Therapist | 2251X0800X | PT60914674 | WA |
Addresses
Primary practice location
3020 Childrens Way # Mc5068
San Diego, CA 92123
Mailing address
3020 Childrens Way # Mc5068
San Diego, CA 92123-4223
Phone (858) 966-5829
Other practice location 1
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 491-9480
Other practice location 2
3020 Childrens Way # Mc5068
San Diego, CA 92123
Phone (858) 966-5829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60914674 | WA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children's Hospital San Diego | Past | Accepting new patients | |
| Rady Children's Hospital San Diego | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Children's Rehabilitation Hospital
- San Diego, CA
- NPI 1174907216
-
- Children's Rehabilitation Hospital
- San Diego, CA
- NPI 1184008229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557532800000",
"number": "1093278228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY # MC5068",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-966-5829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY # MC5068",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "858-966-5829"
}
],
"practiceLocations": [
{
"address_1": "413 Lilly Rd NE",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985065133",
"country_code": "US",
"telephone_number": "360-491-9480",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3020 Childrens Way # Mc5068",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "92123",
"country_code": "US",
"telephone_number": "858-966-5829",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUMAN",
"first_name": "MANDY",
"middle_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-14",
"last_updated": "2019-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WA",
"license": "PT60914674",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.