Tracy Lee Manzoni, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC002862L Issued in PA

Practice address

615 Wyoming Ave
Kingston, PA 18704-3703

Phone

(570) 288-5496

NPI assigned

Jan 25, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy Lee Cave Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Cip Rehabilitation Inc

  • Occupational Therapist
  • Dallas, PA
  • NPI 1669963039

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1225592017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043703",
            "telephone_number": "570-288-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043703",
            "telephone_number": "570-288-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZONI",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC002862L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "CAVE",
            "middle_name": "LEE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Malsom Chiropractic PLLC
• Emily Amanda Malsom, DC
• Bonita M Mancia, M.D.
• Paul R. Mancia, DDS
• Manor Care of Kingston PA LLC
• Michael Marchetti, RN
• Marguerite Mosack, PHD.
• Brian J Marien, MD
• Angela Jean Marinelli, MS, NCC, LPC
• Louis Joseph Mariotti, D. O.

• Occupational Therapist in Kingston, PA
• Providers in Kingston, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.