Individual provider Active NPI

Maria Criselda Manalo, PT, DPT

  • Physical Therapist
  • Royal Oak, MI
National Provider Identifier
1750863197
Registry record updated Sep 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501012851 Issued in MI
Practice address
Ro Beaumont Department of Rehab Services 3601 W 13 Mile
Royal Oak, MI 48073
Phone
(248) 898-5000
NPI assigned
Sep 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2018

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 5501012851 MI Primary

Addresses

Primary practice location

Ro Beaumont Department of Rehab Services 3601 W 13 Mile
Royal Oak, MI 48073

Mailing address

2123 Kennedy Dr
Rochester Hills, MI 48309
Phone (248) 495-2101

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
5501012851MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535760000000",
    "number": "1750863197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 KENNEDY DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48309",
            "telephone_number": "248-495-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RO BEAUMONT DEPARTMENT OF REHAB SERVICES 3601 W 13 MILE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALO",
        "first_name": "MARIA",
        "middle_name": "CRISELDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-01",
        "last_updated": "2018-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2018; 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.