Individual provider Active NPI

Mychal S Manning, DPT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1366798068
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60487 Issued in OR
Practice address
1725 SW Chandler Ave Ste 102
Bend, OR 97702-3249
Phone
(541) 209-6729
Fax
(541) 605-3286
NPI assigned
Jul 31, 2012
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39246 CA
Physical Therapist 225100000X 60487 OR Primary

Addresses

Primary practice location

1725 SW Chandler Ave Ste 102
Bend, OR 97702-3249

Mailing address

20460 Del Coco CT
Bend, OR 97702-9414
Phone (949) 290-5193

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150914002781 OR Practitioner - Physical Therapist in Private Practice 7618126483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manning Physical TherapyGroup PAC ID 6507304433, 2 clinicians

Practice addresses (Care Compare)

1105 SE Centennial St
Bend, OR 97702-1343
Phone (541) 209-6729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39246CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Manning Physical Therapy Physical Therapist CurrentSince Oct 9, 2020 Accepting new patients
Schoenstein Physical Therapy and Worker Selection Testing Inc. Physical Therapist PastSince Apr 1, 2002 Accepting new patients
Prentice Chiropractic LLC PastSince Jul 15, 2022 Accepting new patients
Hand Rehab Associates, Inc. Past Accepting new patients

Locations

1105 SE Centennial St
Bend, OR 97702
Phone (541) 209-6729

1725 SW Chandler Ave
Ste 102
Bend, OR 97702
Phone (458) 600-9345

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1366798068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20460 DEL COCO CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029414",
            "telephone_number": "949-290-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 SW CHANDLER AVE STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023249",
            "telephone_number": "541-209-6729",
            "fax_number": "541-605-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "MYCHAL",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39246",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.