Individual provider Active NPI

Randee Carreon Masangya, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1356487953
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019737-1 Issued in NY
Practice address
330 W 34TH St
15TH FL.
New York, NY 10001-2406
Phone
(212) 947-5770
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 019737-1 NY Primary

Addresses

Primary practice location

330 W 34TH St
15TH FL.
New York, NY 10001-2406

Mailing address

126 Cody PL
Staten Island, NY 10312-1690
Phone (718) 984-8572

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120420000173 NJ Practitioner - Physical Therapist in Private Practice 3173594231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3663 Route 9 N
Old Bridge, NJ 08857-3518
Phone (732) 970-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019737-1NYMDPhysical Therapist
019737NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Body Rehab Center, P.C. Physical Therapist CurrentSince Apr 23, 2014 Accepting new patients

Locations

3663 US Highway 9
Ste 101
Old Bridge, NJ 08857
Phone (732) 591-5858

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356487953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CODY PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121690",
            "telephone_number": "718-984-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 34TH ST",
            "address_2": "15TH FL.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012406",
            "telephone_number": "212-947-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASANGYA",
        "first_name": "RANDEE",
        "middle_name": "CARREON",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019737-1",
            "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 8, 2007; 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.