Organization Active NPI

New Age Enterprises

Doing business as Manale Occupational & Physical Therapy

  • Occupational Therapist
  • Downey, CA
National Provider Identifier
1417227554
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 4566 Issued in CA
Legal business name
NEW AGE ENTERPRISES
Doing business as
Manale Occupational & Physical Therapy
Practice address
7320 Firestone Blvd Ste 105
Downey, CA 90241-4159
Phone
(562) 927-5820
Fax
(562) 684-0102
NPI assigned
Jan 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Ms. Valerie M Mendoza, REGIONAL MANAGER/HR
Title
Regional Manager/HR
Phone
(562) 927-5820

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT 4566 CA Primary
Physical Therapy Clinic/Center 261QP2000X OT 4566 CA

Addresses

Primary practice location

7320 Firestone Blvd Ste 105
Downey, CA 90241-4159

Mailing address

817 W Beverly Blvd Ste 201
Montebello, CA 90640-4265
Phone (562) 927-5820

Other practice location 1

17042 Bellflower Blvd
Bellflower, CA 90706-5950
Phone (562) 991-1324

Other identifiers 1

IdentifierTypeStateIssuer
521108MedicaidCA

Other names 1

  • Manale Occupational & Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120222000114 CA Part B Supplier - Clinic/Group Practice 0648438606 Receives reassigned benefits from 2 practitioners
Practice locations: Bellflower, CA; Downey, CA; Los Angeles, CA
O20130430000398 CA Part A Provider - Home Health Agency 0648438606 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Montebello, CA

Home health agency certification: CCN 059689

Legal name
NEW AGE ENTERPRISES
Doing business as
SGV HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 24, 2015
Last certification
Jul 19, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 28, 2011 in CA
Enrollment address
817 W Beverly Blvd
Ste 206
Montebello, CA 90640-4265
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
SGV Home HealthCCN 059689 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Aug 24, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

7340 Firestone Blvd
Ste 123
Downey, CA 90241
Phone (562) 927-5820

7320 Firestone Blvd
Ste 105
Downey, CA 90241
Phone 5629275820 ext. 100

5161 Pomona Blvd
Ste AND109
Los Angeles, CA 90022

817 W Beverly Blvd
Ste 201
Montebello, CA 90640
Phone (562) 991-1324

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jorge E Manale Individual 5% Or Greater Direct Ownership InterestPresident/Administrator Sep 28, 2011 50%
General Partnership Interest Oct 14, 2014
Corporate DirectorOwner/Board Pres./Administrator Sep 28, 2011 50%
W-2 Managing EmployeeOwner/Board Pres./Administrator Sep 28, 2011 50%
Tina Rose Manale Individual 5% Or Greater Direct Ownership InterestCoo Jan 2, 2024 50%
5% Or Greater Security Interest Jan 2, 2024 50%
General Partnership Interest Jan 2, 2024 50%
Corporate Officer Jan 2, 2024 50%
Corporate Director Jan 2, 2024 50%
W-2 Managing EmployeeAd; Jan 2, 2024 50%
Operational/Managerial Control Jan 2, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1417227554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 W BEVERLY BLVD STE 201",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404265",
            "telephone_number": "562-927-5820",
            "fax_number": "562-684-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 FIRESTONE BLVD STE 105",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414159",
            "telephone_number": "562-927-5820",
            "fax_number": "562-684-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17042 Bellflower Blvd",
            "address_purpose": "LOCATION",
            "city": "Bellflower",
            "state": "CA",
            "postal_code": "907065950",
            "country_code": "US",
            "telephone_number": "562-991-1324",
            "fax_number": "562-502-9862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW AGE ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2020-11-16",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REGIONAL MANAGER/HR",
        "authorized_official_telephone_number": "562-927-5820",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "REGIONAL MANAGER/HR"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 4566",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "OT 4566",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521108",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manale Occupational & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.