Individual provider Active NPI

Bobby Sadiua Mangcoy, P.T.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1508100322
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026088-1 Issued in NY
Practice address
2 West 86 Street Central Park West
Suite 1
New York, NY 10024
Phone
(212) 787-7994
Fax
(212) 595-4716
NPI assigned
Nov 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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 026088-1 NY Primary

Addresses

Primary practice location

2 West 86 Street Central Park West
Suite 1
New York, NY 10024

Mailing address

2 West 86 Street Central Park West
Suite 1
New York, NY 10024
Phone (212) 787-7994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
026088-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Park Physical Medicine and Rehabilitation P.C. PastSince Apr 13, 2020 Accepting new patients

Organizations & group practices 1

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": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1508100322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WEST 86 STREET CENTRAL PARK WEST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-787-7994",
            "fax_number": "212-595-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WEST 86 STREET CENTRAL PARK WEST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-787-7994",
            "fax_number": "212-595-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGCOY",
        "first_name": "BOBBY",
        "middle_name": "SADIUA",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026088-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.