Individual provider Active NPI

Albert Francis Marabillo Manibo, PTA

  • Physical Therapy Assistant
  • Waipahu, HI
National Provider Identifier
1245831718
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA391 Issued in HI
Practice address
94-1388 Moaniani St Ste 243
Waipahu, HI 96797-6606
Phone
(808) 744-5161
Fax
(808) 744-6639
NPI assigned
Nov 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA391 HI Primary

Addresses

Primary practice location

94-1388 Moaniani St Ste 243
Waipahu, HI 96797-6606

Mailing address

94-1388 Moaniani St Ste 243
Waipahu, HI 96797-6606
Phone (808) 744-5161

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA391HIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1245831718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1388 MOANIANI ST STE 243",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967976606",
            "telephone_number": "808-744-5161",
            "fax_number": "808-744-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1388 MOANIANI ST STE 243",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967976606",
            "telephone_number": "808-744-5161",
            "fax_number": "808-744-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIBO",
        "first_name": "ALBERT",
        "middle_name": "FRANCIS MARABILLO",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "HI",
            "license": "PTA391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.