Organization Active NPI

Mangoos Physical Therapy P.C

  • Specialist
  • Bronx, NY
National Provider Identifier
1174916670
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
029005 Issued in NY
Legal business name
MANGOOS PHYSICAL THERAPY P.C
Practice address
903 Sheridan Ave
Suite E
Bronx, NY 10451-3304
Phone
(718) 450-3242
Fax
(718) 450-3217
NPI assigned
Mar 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Authorized official

Name
Dr. Michael Kristian Trangia Mangubat, M.D
Title
Physical Therapist / Ceo
Phone
(718) 450-3242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 029005 NY Primary

Addresses

Primary practice location

903 Sheridan Ave
Suite E
Bronx, NY 10451-3304

Mailing address

903 Sheridan Ave
Suite E
Bronx, NY 10451-3304
Phone (718) 450-3242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150720001596 NY Part B Supplier - Clinic/Group Practice 0749593788 Receives reassigned benefits from 4 practitioners
Practice locations: Astoria, NY; Bronx, NY; Brooklyn, NY; Corona, NY

National Provider Directory

National Provider Directory

Locations

903 Sheridan Ave
Ste E
Bronx, NY 10451
Phone (718) 450-3242

1314 Coney Island Ave
Brooklyn, NY 11230
Phone (718) 377-5300

10603 Corona Ave
Flushing, NY 11368
Phone (917) 745-0091

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1174916670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 SHERIDAN AVE",
            "address_2": "SUITE E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513304",
            "telephone_number": "718-450-3242",
            "fax_number": "718-450-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 SHERIDAN AVE",
            "address_2": "SUITE E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513304",
            "telephone_number": "718-450-3242",
            "fax_number": "718-450-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGOOS PHYSICAL THERAPY P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "MANGUBAT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KRISTIAN TRANGIA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / CEO",
        "authorized_official_telephone_number": "718-450-3242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "029005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.