Individual provider Active NPI

Cathryn Manguilin Pecson

  • Physical Therapist
  • Richmond Hill, NY
National Provider Identifier
1336902055
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
048625 Issued in NY
Practice address
10704 Jamaica Ave
Richmond Hill, NY 11418-2239
Phone
(347) 829-3890
Fax
(347) 829-3888
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 048625 NY Primary

Addresses

Primary practice location

10704 Jamaica Ave
Richmond Hill, NY 11418-2239

Mailing address

10704 Jamaica Ave
Richmond Hill, NY 11418-2239
Phone (347) 829-3890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260318002888 NY Practitioner - Physical Therapist in Private Practice 4284118258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Luna Care Physical Therapy PLLCGroup PAC ID 0840604666, 62 clinicians

Practice addresses (Care Compare)

Pearl River, NY 10965
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048625NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Mar 9, 2026 Accepting new patients

Locations

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1336902055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10704 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182239",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10704 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182239",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECSON",
        "first_name": "CATHRYN",
        "middle_name": "MANGUILIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.