Individual provider Active NPI

Julian Martin Manrique, MPT, OCS

  • Physical Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1417020637
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24615 Issued in CA
Practice address
30212 Tomas
Suite 120
Rancho Santa Margarita, CA 92688-2172
Phone
(949) 709-8770
Fax
(949) 709-4064
NPI assigned
Nov 16, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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 PT24615 CA Primary

Addresses

Primary practice location

30212 Tomas
Suite 120
Rancho Santa Margarita, CA 92688-2172

Mailing address

30212 Tomas
Suite 120
Rancho Santa Margarita, CA 92688-2172
Phone (949) 709-8770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071029000194 CA Practitioner - Physical Therapist in Private Practice 7113813270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hands on Physical Therapy, IncGroup PAC ID 3577548957, 5 clinicians

Practice addresses (Care Compare)

30212 Tomas
Suite 120
Rancho Santa Margarita, CA 92688-2173
Phone (949) 709-8770

Merit-based Incentive Payment System (MIPS)

Final score
22.17 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24615CAMDChiropractor
PT24615CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus on Movement Current Accepting new patients
Hands on Physical Therapy, Inc CurrentSince Jun 28, 2007 Accepting new patients
Focus Physical Therapy, Inc Physical Therapist PastSince Nov 9, 2001 Accepting new patients

Locations

30212 Tomas
Ste 120
Rcho Sta Marg, CA 92688
Phone (949) 709-8770

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, 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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1417020637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30212 TOMAS",
            "address_2": "SUITE 120",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882172",
            "telephone_number": "949-709-8770",
            "fax_number": "949-709-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30212 TOMAS",
            "address_2": "SUITE 120",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882172",
            "telephone_number": "949-709-8770",
            "fax_number": "949-709-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANRIQUE",
        "first_name": "JULIAN",
        "middle_name": "MARTIN",
        "credential": "MPT, OCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.