Individual provider Active NPI

Rosary Moscoso Maningat, PT

  • Physical Therapist
  • Watertown, WI
National Provider Identifier
1679993752
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12619-24 Issued in WI
Practice address
1020 Hill St
Watertown, WI 53094
Phone
(920) 261-0400
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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 12619-24 WI Primary

Addresses

Primary practice location

1020 Hill St
Watertown, WI 53094

Mailing address

1415 W Foster Ave
Chicago, IL 60640-2288
Phone (773) 596-2252

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

State licenses

LicenseStateTypeSpecialty
12619-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1679993752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 W FOSTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402288",
            "telephone_number": "773-596-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 HILL ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "53094",
            "telephone_number": "920-261-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANINGAT",
        "first_name": "ROSARY",
        "middle_name": "MOSCOSO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12619-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.