Manthana Phothisatean, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

052136 Issued in NY

Practice address

30 Burda Ave
New City, NY 10956-1418

Phone

(929) 928-0986

NPI assigned

Feb 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Physical Therapy Occupational Therapy and Rehabilitation ServicGroup PAC ID 0446140446, 529 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Hand Physical Therapist
  • East Meadow, NY
  • NPI 1770540593
  Medicare reassignment Care Compare group NPD
• New York Physical and Occupational Therapy Services, PLLC

  dba New York Therapy And Wellness

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1356703631
  Medicare reassignment NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • White Plains, NY
  • NPI 1629825591
  NPD
• Amerirehab Services PT PC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1184061624
  NPD (past)
• Ospre PT, PC

  • Physical Therapist
  • New City, NY
  • NPI 1831498245
  NPD (past)

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1417541889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURDA AVE",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109561418",
            "telephone_number": "929-928-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BURDA AVE",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109561418",
            "telephone_number": "929-928-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOTHISATEAN",
        "first_name": "MANTHANA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "011579",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin A Petersel, LMFT, LMHC
• Richard A Petix, D.D.S
• Joann Phenix
• Mercy W Philip, RPH
• Phillips Hill Pain MGMT., PC
• Physiatry PLLC
• Elizabeth Piccolo, PMHNP
• Chad Pilieri
• Anna Pisano
• Pivotal Performance Occupational Therapy LLC (PivOTal Performance)

• Physical Therapist in New City, NY
• Providers in New City, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.