Individual provider Active NPI

Christine M Manyak, PT

  • Physical Therapist
  • Auburn, MA
National Provider Identifier
1275512139
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7467 Issued in MA
Practice address
385 Southbridge St
Auburn, MA 01501-2498
Phone
(508) 721-1101
Fax
(508) 721-1102
NPI assigned
Jan 10, 2006
Last updated
Mar 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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 7467 MA Primary

Addresses

Primary practice location

385 Southbridge St
Auburn, MA 01501-2498

Mailing address

5 Neponset St FL ST2
Worcester, MA 01606-2714
Phone (508) 368-5532

Other identifiers 19

IdentifierTypeStateIssuer
Y67940OtherBLUE SHIELD INDEMNITY
0318957MedicaidMA
042472266OtherHEALTHCARE VALUE MANAGEME
2779432OtherCIGNA HEALTH PLAN
650017413OtherRAILROAD MEDICARE
7038566OtherAETNA US HEALTHCARE
Y67940OtherBLUE SHIELD HMO BLUE
Y68460OtherMEDICARE B
042472266OtherPRIVATE HEALTHCARE SYSTEM
785958OtherMVP HEALTH CARE
042472266OtherTHREE RIVERS
2779432001OtherCIGNA PAL ID
43208OtherFALLON COMMUNITY HEALTH
45959OtherCHILDRENS MEDICAL SECURIT
0318957OtherMEDICAID WELFARE
35481155OtherCIGNA HEALTHSOURCE
A052AOtherHARVARD PILGRIM HEALTHCAR
042472266OtherONE HEALTH PLAN
Y67940OtherBLUE CARE ELECT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060825000147 MA Practitioner - Physical Therapist in Private Practice 0547263923 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Physical Therapist CurrentSince Jan 17, 2000 Accepting new patients
Reliant Medical Group, Inc CurrentSince Jan 17, 2000 Accepting new patients

Locations

385 Southbridge St
Auburn, MA 01501
Phone (508) 721-1101

20 Southbridge Rd
Charlton, MA 01507
Phone (508) 248-4141

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl ST2
Worcester, MA 01606

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

  • Direct secure messaging: christine.manyak.npi1275512139.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1275512139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL ST2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-368-5532",
            "fax_number": "508-721-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 SOUTHBRIDGE ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012498",
            "telephone_number": "508-721-1101",
            "fax_number": "508-721-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYAK",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "7467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "Y67940",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0318957",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MANAGEME",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "2779432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650017413",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7038566",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "Y67940",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "Y68460",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "785958",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL ID",
            "identifier": "2779432001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH",
            "identifier": "43208",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "45959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELFARE",
            "identifier": "0318957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "35481155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "A052A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "Y67940",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, MA

Sources for this page

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