Individual provider Active NPI

Manisha Patel

  • Physical Therapist
  • Pflugerville, TX
National Provider Identifier
1598132052
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1330262 Issued in TX
Practice address
18112 Leccion Dr
Pflugerville, TX 78660-6460
Phone
(913) 232-1954
NPI assigned
Aug 31, 2015
Last updated
May 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-04339 KS
Physical Therapist 225100000X 1330262 TX Primary

Addresses

Primary practice location

18112 Leccion Dr
Pflugerville, TX 78660-6460

Mailing address

18112 Leccion Dr
Pflugerville, TX 78660-6460
Phone (913) 232-1954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200416001591 MO Practitioner - Physical Therapist in Private Practice 2961719331 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-04339KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc. Physical Therapist CurrentSince Apr 7, 2020 Accepting new patients

Locations

15950 Manchester Rd
Ellisville, MO 63011
Phone (636) 220-2748

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

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

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1598132052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18112 LECCION DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786606460",
            "telephone_number": "913-232-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18112 LECCION DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786606460",
            "telephone_number": "913-232-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-04339",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1330262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pflugerville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.