Max Mangabat, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12397 Issued in AZ

Practice address

13967 W Grand Ave
Suite C-100
Surprise, AZ 85374-3732

Phone

(623) 474-3952

Fax

(623) 474-3953

NPI assigned

Aug 15, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as group

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: max.mangabat.p6@direct.athleticoltd.nextgenshare.com

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.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  AZ

  Medicare reassignment Care Compare group NPD
• Ati Holdings of Arizona, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1871570309
  Medicare reassignment NPD
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1558318170
  NPD (past)
• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1639624075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY",
            "address_2": "SUITE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "telephone_number": "480-706-1161",
            "fax_number": "480-706-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13967 W GRAND AVE",
            "address_2": "SUITE C-100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743732",
            "telephone_number": "623-474-3952",
            "fax_number": "623-474-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGABAT",
        "first_name": "MAX",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "12397",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Maldonado
• Ernest Mall, NP
• Elaine Carmella Mamola, RDH
• Jennifer Dianne Man, SLPA
• Alicia Camille Mancini, RPH
• Tanya Mangini
• Harleen Manhas, RBT
• Bradley Duncan Manning
• Jennifer Mansfield
• Ella Mantiply, DPT

• Physical Therapist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.