Individual provider Active NPI

Janine Runions Mantzaris, P.T.

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1386836054
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017086 Issued in NY
Practice address
464 City Island Ave.
Bronx, NY 10464
Phone
(718) 885-1079
Fax
(718) 885-1089
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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 017086 NY Primary

Addresses

Primary practice location

464 City Island Ave.
Bronx, NY 10464

Mailing address

97 Winters St
Bronx, NY 10464
Phone (718) 885-1079

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080207000185 NY Practitioner - Physical Therapist in Private Practice 2860575305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

464 City Island Ave
Bronx, NY 10464-1215
Phone (718) 885-1079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017086NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Janine Mantzaris Physical Therapy PC Physical Therapist CurrentSince Jun 28, 2004 Accepting new patients
Hudson in Home Physical Therapy and Occupational Therapy PLLC Physical Therapist PastSince Jan 4, 2022 Accepting new patients
Janine Mantzaris Physical Therapy PC Past Accepting new patients

Locations

464 City Island Ave
Bronx, NY 10464
Phone (718) 885-1079

Organizations & group practices 3

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1386836054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 WINTERS ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10464",
            "telephone_number": "718-885-1079",
            "fax_number": "718-885-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 CITY ISLAND AVE.",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10464",
            "telephone_number": "718-885-1079",
            "fax_number": "718-885-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTZARIS",
        "first_name": "JANINE",
        "middle_name": "RUNIONS",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.