Ronnie Santiago Mangulabnan Jr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

009865 Issued in CT

Practice address

44 Old Ridgefield Rd Ste 213
Wilton, CT 06897-3014

Phone

(877) 407-3422

NPI assigned

Nov 7, 2014

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 CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehab PT CT, LLCGroup PAC ID 8820235575, 76 clinicians

Practice addresses (Care Compare)

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.

• Fox Rehab PT CT, LLC

  • Physical Therapist
  • Wilton, CT
  • NPI 1245584234
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1174929848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 OLD RIDGEFIELD RD STE 213",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 OLD RIDGEFIELD RD STE 213",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973014",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGULABNAN",
        "first_name": "RONNIE",
        "middle_name": "SANTIAGO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Elizabeth Macken, MD
• Vinay Madan, MD
• Michael Matthew Maksymiuk, D.M.D.
• Racquel Malicad, PT
• Ahsan Fayyaz Malik, M.D.
• Arthur Manoli III, M.D.
• Michael Marchetti, D.O.
• Jessica Marie Marcotte
• Margaret Creeth, LPC
• Joseph Marini, PT, DPT

• Physical Therapist in Wilton, CT
• Providers in Wilton, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.