Patricia Fannya Manchak, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

J1-0001028 Issued in DE

Practice address

2714 Philadelphia Pike
Claymont, DE 19703-2568

Phone

(302) 408-7310

Fax

(302) 416-4817

NPI assigned

Apr 21, 2006

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

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Delaware LLCGroup PAC ID 9638506702, 17 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 and National Provider Directory roles.

• Ivyrehab Delaware LLC

  • Physical Medicine & Rehabilitation Physician
  • Claymont, DE
  • NPI 1750927141

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Phoenix Rehabilitation and Health Services of Delaware Inc

  • Physical Therapist
  • Cranberry Township, PA
  • NPI 1912951021

  DE

  Medicare reassignment NPD
• Southern Delaware Physical Therapy, Inc.

  • Physical Therapist
  • Lewes, DE
  • NPI 1588690622
  NPD (past)

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1487610366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 PHILADELPHIA PIKE",
            "city": "CLAYMONT",
            "state": "DE",
            "postal_code": "197032568",
            "telephone_number": "302-408-7310",
            "fax_number": "302-416-4817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Brandywine Parkway",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198031492",
            "country_code": "US",
            "telephone_number": "302-479-0880",
            "fax_number": "302-479-0550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHAK",
        "first_name": "PATRICIA",
        "middle_name": "FANNYA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT009427L",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0001028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0479677000",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487610366",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPCI",
            "identifier": "1487610366",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "254215",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102373515-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00692875",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5916630",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Adoption Associates, LTD.
• Jenna Lea Mahalik, BS
• Lucy N Maina
• Patrick Malone
• James Francis Malseed, M.ED., ATC
• Emanuela Mannino, DPT
• Courtney Marinucci
• Annette Marks
• Destinee Martin-Clarke
• Elizabeth Mattey

• Physical Therapist in Claymont, DE
• Providers in Claymont, DE by specialty
• Physical Therapist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.