Individual provider Active NPI

Emily Mantz

  • Physical Therapist
  • Fairfield, CT
National Provider Identifier
1215703814
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14266 Issued in CT
Practice address
2373 Black Rock Tpke
Fairfield, CT 06825-3229
Phone
(203) 659-3056
NPI assigned
Nov 27, 2023
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14266 CT Primary

Addresses

Primary practice location

2373 Black Rock Tpke
Fairfield, CT 06825-3229

Mailing address

47 N Main St
West Hartford, CT 06107-1926

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218002656 CT Practitioner - Physical Therapist in Private Practice 7416306378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anb-Ptsma Holdings IncGroup PAC ID 4789572926, 190 clinicians

Practice addresses (Care Compare)

2373 Black Rock Tpke
Fairfield, CT 06825-3229
Phone (203) 659-4898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Nov 28, 2023 Accepting new patients

Locations

2373 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 659-3056

103 E Main St
Unit C
Plainville, CT 06062
Phone (860) 517-8885

47 N Main St
West Hartford, CT 06107
Phone (860) 409-4595

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1215703814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253229",
            "telephone_number": "203-659-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTZ",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.