Individual provider Active NPI

Rae Mannino, OT

  • Occupational Therapist
  • Cos Cob, CT
National Provider Identifier
1154619716
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
015452-1 Issued in NY
Practice address
35 River Rd
Cos Cob, CT 06807-2759
Phone
(203) 422-0679
Fax
(203) 422-0931
NPI assigned
Jul 18, 2011
Last updated
Nov 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 015452-1 NY Primary
Occupational Therapist 225X00000X 3873 CT

Addresses

Primary practice location

35 River Rd
Cos Cob, CT 06807-2759

Mailing address

35 River Rd
Cos Cob, CT 06807-2759
Phone (203) 422-0679

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3873CTMDClinical Neuropsychologist
015452NYMDPhysical Therapist
015452-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Sos PT PC Occupational Therapist PastSince Feb 1, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1154619716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RIVER RD",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072759",
            "telephone_number": "203-422-0679",
            "fax_number": "203-422-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 RIVER RD",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072759",
            "telephone_number": "203-422-0679",
            "fax_number": "203-422-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "RAE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015452-1",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "3873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cos Cob, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.