Individual provider Active NPI

Patrick Maness, MSOT

  • Occupational Therapist
  • Port Saint Lucie, FL
National Provider Identifier
1619404787
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT21001 Issued in FL
Practice address
1729 NW Saint Lucie West Blvd # 1141
Port Saint Lucie, FL 34986-2501
Phone
(772) 206-0629
Fax
(949) 437-3168
NPI assigned
May 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 OT21001 FL Primary

Addresses

Primary practice location

1729 NW Saint Lucie West Blvd # 1141
Port Saint Lucie, FL 34986-2501

Mailing address

1729 NW Saint Lucie West Blvd # 1141
Port Saint Lucie, FL 34986-2501
Phone (772) 206-0629

Other identifiers 1

IdentifierTypeStateIssuer
120071300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201014001320 FL Practitioner - Occupational Therapist in Private Practice 8729408695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1729 NW Saint Lucie W Blvd
Suite 1141
Port St Lucie, FL 34986-2501
Phone (561) 802-8074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT21001FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Sep 12, 2020 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Sep 12, 2020 Accepting new patients
Maness Holding Company LLC CurrentSince Feb 10, 2022 Accepting new patients

Locations

1729 NW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (386) 264-4899

Organizations & group practices 3

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1619404787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 NW SAINT LUCIE WEST BLVD # 1141",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862501",
            "telephone_number": "772-206-0629",
            "fax_number": "949-437-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 NW SAINT LUCIE WEST BLVD # 1141",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862501",
            "telephone_number": "772-206-0629",
            "fax_number": "949-437-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANESS",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MSOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-18",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT21001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120071300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.