Individual provider Active NPI

Jessie Anne Manlutac

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1649190885
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014434 Issued in NY
Practice address
84-25 Elmhurst Avenue, Apt 3P
Elmhurst, NY 11373
Phone
(347) 829-3890
Fax
(347) 829-3888
NPI assigned
Jul 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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 014434 NY Primary

Addresses

Primary practice location

84-25 Elmhurst Avenue, Apt 3P
Elmhurst, NY 11373

Mailing address

84-25 Elmhurst Avenue, Apt 3P
Elmhurst, NY 11373
Phone (347) 829-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1649190885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84-25 ELMHURST AVENUE, APT 3P",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84-25 ELMHURST AVENUE, APT 3P",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "347-829-3890",
            "fax_number": "347-829-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLUTAC",
        "first_name": "JESSIE ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-17",
        "last_updated": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.