Individual provider Active NPI

Alexandra Kristine Mangus, PT, DPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1629629795
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
044878 Issued in NY
Practice address
33 Richmond Hill Rd
Staten Island, NY 10314-5950
Phone
(718) 982-6340
NPI assigned
Sep 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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 044878 NY Primary

Addresses

Primary practice location

33 Richmond Hill Rd
Staten Island, NY 10314-5950

Mailing address

900 Route 9 N Ste 410
Woodbridge, NJ 07095-1003
Phone (201) 801-7141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200221001186 NY Practitioner - Physical Therapist in Private Practice 3072940543 Reassigns benefits to 1 organization
I20241031000053 NJ Practitioner - Physical Therapist in Private Practice 3072940543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

10 Route 31 N
Pennington, NJ 08534-1606
Phone (609) 890-4450

Merit-based Incentive Payment System (MIPS)

Final score
21.39 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Jan 7, 2020 Accepting new patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

981 US Highway 22
Bridgewater, NJ 08807
Phone (908) 231-0511

255 Monmouth Rd
Ste 4
Oakhurst, NJ 07755
Phone (732) 660-1560

10 Route 31 N
Pennington, NJ 08534
Phone (609) 303-3064

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

900 Route 9 N
Ste 410
Woodbridge, NJ 07095

2133 Ralph Ave
Brooklyn, NY 11234
Phone (718) 451-1400

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

1351 Forest Ave
Staten Island, NY 10302
Phone (718) 390-0060

4363 Amboy Rd
Staten Island, NY 10312
Phone (718) 967-3900

33 Richmond Hill Rd
Staten Island, NY 10314
Phone (718) 982-5358

1243 Woodrow Rd
Unit 323
Staten Island, NY 10309
Phone (718) 844-5350

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": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1629629795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 9 N STE 410",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951003",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 RICHMOND HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145950",
            "telephone_number": "718-982-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUS",
        "first_name": "ALEXANDRA",
        "middle_name": "KRISTINE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.