Individual provider Active NPI

Renelita Cruz Manuel, P.T.

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1669503660
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024777 Issued in NY
Practice address
330 Seguine Ave
Staten Island, NY 10309-3941
Phone
(718) 356-9222
Fax
(718) 605-4729
NPI assigned
Mar 8, 2007
Last updated
Aug 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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 024777 NY Primary

Addresses

Primary practice location

330 Seguine Ave
Staten Island, NY 10309-3941

Mailing address

153 Cannon Ave
Staten Island, NY 10314-4607
Phone (718) 690-4238

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
024777NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Staten Island Hands on Physical Therapy PC Physical Therapist Past Accepting new patients
Interpublic Medical PC Past Accepting new patients

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, 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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1669503660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 CANNON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144607",
            "telephone_number": "718-690-4238",
            "fax_number": "718-494-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SEGUINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093941",
            "telephone_number": "718-356-9222",
            "fax_number": "718-605-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "RENELITA",
        "middle_name": "CRUZ",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024777",
            "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 Aug 13, 2008; 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.