Eric Manzano, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070007573 Issued in IL

Practice address

306 W Mill St
Carbondale, IL 62901-2727

Phone

(618) 529-3060

NPI assigned

Sep 21, 2008

Sex

Male

Sole proprietor

Yes

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

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myofascial Release of Southern IllinoisGroup PAC ID 4284867151, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Myofascial Release of Southern Illinois

  • Rehabilitation Clinic/Center
  • Carbondale, IL
  • NPI 1851722946

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1356591895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W MILL ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629012727",
            "telephone_number": "618-529-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W MILL ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629012727",
            "telephone_number": "618-529-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "ERIC",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-21",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070007573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurveen Pal Singh Malhotra, M.D.
• Adedoyin Idayat Malik, DDS
• Is-Haq Malik, MD
• Sara B Malone, MD
• Desma Elizabeth Manigault-McElveen
• Tara Manzano, OTR/L
• Allen Wayne Mardis, ATC
• Abbey Margolis, MSW, LSW
• Marion Eye Centers LTD
• Marion Eye Centers LTD.

• Physical Therapist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.