Pankaj Mamtora, R.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501014195 Issued in MI

Practice address

26400 W 12 Mile Rd Ste 25
Southfield, MI 48034-1774

Phone

(248) 565-4000

Fax

(248) 565-4030

NPI assigned

Feb 22, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, TX2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physical Therapy Services, Inc.

  • Rehabilitation Clinic/Center
  • Southfield, MI
  • NPI 1639292014

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Theramedic Rehab and Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Stafford, TX
  • NPI 1346798170
  Medicare reassignment Authorized official
• Theramedic Rehab Inc.

  • Rehabilitation Clinic/Center
  • Stafford, TX
  • NPI 1902104607
  NPD Authorized official
• Harone, PA

  • Optometrist
  • Houston, TX
  • NPI 1194751636
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1104123561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD STE 25",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341774",
            "telephone_number": "248-565-4000",
            "fax_number": "248-565-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD STE 25",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341774",
            "telephone_number": "248-565-4000",
            "fax_number": "248-565-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMTORA",
        "first_name": "PANKAJ",
        "name_prefix": "Mr.",
        "credential": "R.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Os'Shanae Shautia Malone
• Hollie Marie Maltese
• Meenal Malviya, M.D.
• Vinay Kumar Malviya, MD
• Monika Katarzyna Malysa-Houben, NP STUDENT
• Rajendra Kumar Manam, MD
• Amanda Mancino
• Steve P Mandell, MALLP
• Jourdan Manders
• Mane Medical Equipment & Supplies, Inc.

• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.