Ivan Santos Manasan, DPT, CSRS, PTRP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24704 Issued in MD

Practice address

4922 Lasalle Rd
Hyattsville, MD 20782-3302

Phone

(301) 864-2333

NPI assigned

Jun 6, 2014

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

At Home RehabGroup PAC ID 9335512300, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• At Home Rehab

  • Home Health Agency
  • Columbia, MD
  • NPI 1992416572
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1518370592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303903",
            "telephone_number": "818-731-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 LASALLE RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823302",
            "telephone_number": "301-864-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANASAN",
        "first_name": "IVAN",
        "middle_name": "SANTOS",
        "credential": "DPT, CSRS, PTRP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esraa Malash
• Malcom Grow
• Glory Maldonado Ortega
• Yewunetu Dessalegn Malefia
• Aileen Nkemtaji Malou
• Jones Manga
• Geneviva Neba Manka
• Bobby Mann, D.D.S.
• Nia Mann
• Kadijatu Mariama Mansaray

• Physical Therapist in Hyattsville, MD
• Providers in Hyattsville, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.