Individual provider Active NPI

Alec Menge

  • Massage Therapist
  • Brooklyn, NY
National Provider Identifier
1265201875
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
026605-01 Issued in NY
Practice address
9711 3Rd Ave
Brooklyn, NY 11209-7717
Phone
(702) 907-7171
NPI assigned
Dec 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 026605-01 NY Primary

Addresses

Primary practice location

9711 3Rd Ave
Brooklyn, NY 11209-7717

Mailing address

9508 Avenue L
Brooklyn, NY 11236-4811

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
026605-01NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bonafide Acupuncture Single Specialty CurrentSince Mar 31, 2024 Accepting new patients

Locations

9508 Avenue L
Brooklyn, NY 11236
Phone (718) 444-3126

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1265201875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9508 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097717",
            "telephone_number": "702-907-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGE",
        "first_name": "ALEC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "026605-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.