Organization Active NPI

Manhattan Physical Medicine & Rehabilitation, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
National Provider Identifier
1306050604
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MANHATTAN PHYSICAL MEDICINE & REHABILITATION, PLLC
Practice address
133 E 58TH St Ste 811
New York, NY 10022
Phone
(212) 472-0077
Fax
(212) 472-4127
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Authorized official

Name
Katie E Cameron
Title
Office Manager
Phone
(212) 472-0077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

133 E 58TH St Ste 811
New York, NY 10022

Mailing address

133 E 58TH St Ste 811
New York, NY 10022-1299
Phone (212) 472-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180713000139 NY Part B Supplier - Clinic/Group Practice 2961758404 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

1841 Broadway
Rm 508
New York, NY 10023
Phone (212) 245-0911

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1306050604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST STE 811",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221299",
            "telephone_number": "212-472-0077",
            "fax_number": "212-472-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST STE 811",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-472-0077",
            "fax_number": "212-472-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN PHYSICAL MEDICINE & REHABILITATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "212-472-0077"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.