Individual provider Active NPI

Minglanilla Celis Mataga

  • Physical Therapist
  • New York, NY
National Provider Identifier
1639487721
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032140-1 Issued in NY
Practice address
229 E 21St St
Suite 1
New York, NY 10010-6433
Phone
(212) 473-3703
Fax
(212) 473-3709
NPI assigned
Sep 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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 032140-1 NY Primary

Addresses

Primary practice location

229 E 21St St
Suite 1
New York, NY 10010-6433

Mailing address

229 E 21St St
Suite 1
New York, NY 10010-6433
Phone (212) 473-3703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000410 NY Practitioner - Physical Therapist in Private Practice 3779762893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032140-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bukhman MD PC CurrentSince Jan 18, 2020 Accepting new patients
Oasis Professional Management Group LTD. Past Accepting new patients
Org Medical PLLC PastSince Apr 1, 2008 Accepting new patients
Advanced Professional Marketing, Inc. Past Accepting new patients

Locations

651 Academy St
New York, NY 10034
Phone (212) 569-2035

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1639487721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E 21ST ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106433",
            "telephone_number": "212-473-3703",
            "fax_number": "212-473-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 E 21ST ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106433",
            "telephone_number": "212-473-3703",
            "fax_number": "212-473-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAGA",
        "first_name": "MINGLANILLA",
        "middle_name": "CELIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032140-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.