Aneesh Achankunju Mampachail, PT DPT CLT CKTP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT32687 Issued in FL

Practice address

600 W North Blvd Ste D
Leesburg, FL 34748-5000

Phone

(352) 787-9300

NPI assigned

May 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• The Villages Rehabilitation Services LLC

  • Rehabilitation Clinic/Center
  • Lady Lake, FL
  • NPI 1407922735
  NPD (past)

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1316502446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W NORTH BLVD STE D",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485000",
            "telephone_number": "352-787-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W NORTH BLVD STE D",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485000",
            "telephone_number": "352-787-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMPACHAIL",
        "first_name": "ANEESH",
        "middle_name": "ACHANKUNJU",
        "name_prefix": "Dr.",
        "credential": "PT DPT CLT CKTP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L. Maiello, M.D.
• Annamaria Maldonado, ARNP
• Diane Malecki, PTA
• Rolando M Malibiran, MD
• Leslie Malnasi, MD
• Samantha Alyse Mancino, PT,DPT
• Arlinda Mango
• Janessa Mangulabnan, PT
• Michael Francis Manson, M.S.S.W.
• Manuel Alvarado MD PA

• Physical Therapist in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.