Individual provider Active NPI

Lisa-Anne Mango, MSPT

  • Physical Therapist
  • Floral Park, NY
National Provider Identifier
1609908540
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023629-1 Issued in NY
Practice address
162 Jericho Tpke
Floral Park, NY 11001-2006
Phone
(516) 326-2525
Fax
(516) 326-2538
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 023629-1 NY Primary

Addresses

Primary practice location

162 Jericho Tpke
Floral Park, NY 11001-2006

Mailing address

194 Pond View LN
Smithtown, NY 11787-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000688 NY Practitioner - Physical Therapist in Private Practice 7719942499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

50 Glen Cove Rd
Greenvale, NY 11548-1062
Phone (516) 626-8787

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023629-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro PT OT and SLP Health PLLC Physical Therapist CurrentSince Mar 6, 2024 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Aug 15, 2022 Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

1000 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 466-4700

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

Organizations & group practices 2

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609908540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 POND VIEW LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012006",
            "telephone_number": "516-326-2525",
            "fax_number": "516-326-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGO",
        "first_name": "LISA-ANNE",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023629-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.