Individual provider Active NPI

Kristina Ellen Manniello, OT

  • Hand Occupational Therapist
  • Summerville, SC
National Provider Identifier
1639238975
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
3313 Issued in MA
Practice address
1022 Mount Whitney Dr
Summerville, SC 29483-3318
Phone
(413) 949-0986
NPI assigned
Dec 6, 2006
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 3313 MA Primary

Addresses

Primary practice location

1022 Mount Whitney Dr
Summerville, SC 29483-3318

Mailing address

1022 Mount Whitney Dr
Summerville, SC 29483-3318
Phone (413) 949-0986

Other identifiers 1

IdentifierTypeStateIssuer
0359068MedicaidMA

Other names 1

  • Kristina E Lacroix Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909000679 SC Practitioner - Occupational Therapist in Private Practice 2365414307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Cooper Physician Group LLCGroup PAC ID 1254775687, 126 clinicians

Practice addresses (Care Compare)

1022 Mount Whitney Dr
Summerville, SC 29483-3318
Phone (413) 949-0986

880 Island Park Dr
Unit 230
Daniel Island, SC 29492-2902
Phone (843) 380-9330

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
80.11
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3313MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Cooper Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
East Cooper Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Hand Past Accepting new patients
East Cooper Physician Group LLC Past Accepting new patients

Locations

880 Island Park Dr
Unit 230
Daniel Island, SC 29492
Phone (843) 380-9330

3400 Salterbeck St
Ste 100B
Mt Pleasant, SC 29466
Phone (843) 856-3262

851 Leonard Fulghum Dr
Ste 101
Mt Pleasant, SC 29464
Phone (843) 884-2133

202 Nexton Square Dr
Summerville, SC 29486
Phone (843) 420-9001

Organizations & group practices 5

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1639238975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 MOUNT WHITNEY DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294833318",
            "telephone_number": "413-949-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 MOUNT WHITNEY DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294833318",
            "telephone_number": "413-949-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNIELLO",
        "first_name": "KRISTINA",
        "middle_name": "ELLEN",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MA",
            "license": "3313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0359068",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "LACROIX",
            "middle_name": "E",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.