NPIMap

Organization Active NPI

Advanced Manuel Therapy Institute 1 LLC

  • Physical Therapist
  • Henderson, NV
National Provider Identifier
1740496272
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1719 Issued in NV
Legal business name
ADVANCED MANUEL THERAPY INSTITUTE 1 LLC
Practice address
2625 W Horizon Ridge Pkwy
Suite 120
Henderson, NV 89052-2896
Phone
(702) 896-0383
Fax
(702) 889-0383
NPI assigned
May 14, 2007
Last updated
Jun 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Michel S Rantissi, DPT, MOT, MTCNPI 1912051632
Title
Owner
Phone
(702) 896-0383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1735 NV
Physical Therapist 225100000X 1719 NV Primary
Occupational Therapist 225X00000X 0663 NV
Occupational Therapist 225X00000X 0662 NV

Addresses

Primary practice location

2625 W Horizon Ridge Pkwy
Suite 120
Henderson, NV 89052-2896

Mailing address

2625 W Horizon Ridge Pkwy
Suite 120
Henderson, NV 89052-2896
Phone (702) 896-0383

Other identifiers 5

IdentifierTypeStateIssuer
V101391OtherNVPTAN
V101392OtherNVPTAN
V101389OtherNVPTAN
V101390OtherNVPTAN
V101393OtherNVPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090617000312 NV Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7810922622 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Las Vegas, NV; North Las Vegas, NV; Henderson, NV

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Advanced Manuel Therapy Institute 1 LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6424 N Losee Rd
Ste 120
North Las Vegas, NV 89086
Phone (702) 896-0383

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1740496272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522896",
            "telephone_number": "702-896-0383",
            "fax_number": "702-889-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522896",
            "telephone_number": "702-896-0383",
            "fax_number": "702-889-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MANUEL THERAPY INSTITUTE 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "RANTISSI",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-896-0383",
        "authorized_official_credential": "DPT, MOT, MTC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1735",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1719",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "0663",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "0662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101391",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101392",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101389",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101390",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101393",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.