M. P. Nisperos, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40QA01110500 Issued in NJ

Practice address

517 Central Ave Ste 1
Orange, NJ 07050-1433

Phone

(973) 414-1357

NPI assigned

Feb 26, 2007

Last updated

May 31, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Mangaoang Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Coast Rehabilitation Services LLCGroup PAC ID 9931333705, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Coast Rehabilitation Services LLC

  • Physical Therapy Clinic/Center
  • Kenilworth, NJ
  • NPI 1417228917

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ascend Psychiatry, PC

  • Psychiatry Physician
  • Union, NJ
  • NPI 1457215469
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1285760710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 LINDEN AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811805",
            "telephone_number": "973-704-7734",
            "fax_number": "855-631-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 CENTRAL AVE STE 1",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070501433",
            "telephone_number": "973-414-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISPEROS",
        "first_name": "M. P.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "PT40QA01110500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "MANGAOANG",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Orange, NJ
• Providers in Orange, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.