Individual provider Active NPI

Ladybird Manangan Reyes, PT

  • Pediatric Physical Therapist
  • Yonkers, NY
National Provider Identifier
1750696530
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
017803 Issued in NY
Practice address
60 Lee Ave
Yonkers, NY 10705-4724
Phone
(845) 300-2785
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 017803 NY
Pediatric Physical Therapist 2251P0200X 017803 NY Primary

Addresses

Primary practice location

60 Lee Ave
Yonkers, NY 10705-4724

Mailing address

508 N Imperial Ave Apt B
Ontario, CA 91764-4089
Phone (845) 300-2785

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
017803NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skille Therapeutic and Child Development Center LLC CurrentSince Jan 26, 2022 Accepting new patients
Ladybird Clinical Rehab PT PC Physical Therapist Past Accepting new patients
California Sensory and Development Gym L.L.C Pediatrics PastSince Dec 5, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1750696530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N IMPERIAL AVE APT B",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644089",
            "telephone_number": "845-300-2785",
            "fax_number": "347-810-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 LEE AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107054724",
            "telephone_number": "845-300-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "LADYBIRD",
        "middle_name": "MANANGAN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017803",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "017803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; 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.