Individual provider Active NPI

Jan Mariness Maniwan, OTR/L

  • Occupational Therapist
  • Glendale, CA
National Provider Identifier
1598510315
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13864 Issued in CA
Practice address
805 Glenvista Dr
Glendale, CA 91206-2619
Phone
(818) 634-9580
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13864 CA Primary

Addresses

Primary practice location

805 Glenvista Dr
Glendale, CA 91206-2619

Mailing address

1011 N Louise St Apt 5
Glendale, CA 91207-1927
Phone (818) 940-6923

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820002105 CA Practitioner - Occupational Therapist in Private Practice 7315446895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A Plus Care LLCGroup PAC ID 1850722430, 10 clinicians

Practice addresses (Care Compare)

Los Angeles, CA 90025
Phone (323) 918-5505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13864CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Care LLC CurrentSince Jun 6, 2025 Accepting new patients

Locations

12100 Wilshire Blvd
Ste 800
Los Angeles, CA 90025
Phone (310) 383-6610

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": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1598510315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N LOUISE ST APT 5",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071927",
            "telephone_number": "818-940-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 GLENVISTA DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062619",
            "telephone_number": "818-634-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIWAN",
        "first_name": "JAN MARINESS",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "13864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.