Active NPI
Manas G. Bastha, RPT
- Physical Therapist
- Southfield, MI
National Provider Identifier
1770877482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501014855
- Practice address
- 26250 Northwestern Hwy
Ste 100
Southfield, MI 48076-3955 - Phone
- (248) 809-3095
- Fax
- (947) 282-8950
- NPI assigned
- May 31, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501014855 | MI | Primary |
Addresses
Primary practice location
26250 Northwestern Hwy
Ste 100
Southfield, MI 48076-3955
Mailing address
26250 Northwestern Hwy
Ste 100
Southfield, MI 48076-3955
Phone (248) 809-3095
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Center of Oak Park LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1770877482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26250 NORTHWESTERN HWY",
"address_2": "STE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763955",
"telephone_number": "248-809-3095",
"fax_number": "947-282-8950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26250 NORTHWESTERN HWY",
"address_2": "STE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763955",
"telephone_number": "248-809-3095",
"fax_number": "947-282-8950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTHA",
"first_name": "MANAS",
"middle_name": "G.",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-31",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501014855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.