Individual provider Active NPI

Mark Rex Mahnensmith, PT, DPT, CSCS

  • Physical Therapist
  • Warwick, RI
National Provider Identifier
1770879124
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02905 Issued in RI
Practice address
535 Centerville Rd Ste 101
Warwick, RI 02886-4376
Phone
(401) 737-6011
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0400090284 VT
Physical Therapist 225100000X 2305206947 VA
Physical Therapist 225100000X 3680 NH
Physical Therapist 225100000X PT02905 RI Primary

Addresses

Primary practice location

535 Centerville Rd Ste 101
Warwick, RI 02886-4376

Mailing address

535 Centerville Rd Ste 101
Warwick, RI 02886-4376
Phone (401) 737-6011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160715000256 RI Practitioner - Physical Therapist in Private Practice 5698947182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy LLCGroup PAC ID 1951295187, 73 clinicians

Practice addresses (Care Compare)

535 Centerville Rd
Suite 101
Warwick, RI 02886-4376
Phone (401) 737-4581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT02905RIMDPhysical Therapist
2305206947VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy, LLC Physical Therapist CurrentSince Jun 13, 2016 Accepting new patients
Cioffredi & Associates Physical Therapy, LLC Physical Therapist PastSince May 1, 2008 Accepting new patients
Advanced Center for Physical Therapy, PLC Past Accepting new patients
Phoenix Rehabilitation and Health Services of Virginia, LLC Physical Therapist PastSince Apr 4, 2005 Accepting new patients

Locations

3461 S County Trl
Ste 304
East Greenwich, RI 02818
Phone (401) 398-7988

52 Frenchtown Rd
North Kingstown, RI 02852
Phone (401) 519-5222

535 Centerville Rd
Ste 101
Warwick, RI 02886
Phone (401) 737-4581

Organizations & group practices 4

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1770879124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD STE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864376",
            "telephone_number": "401-737-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD STE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864376",
            "telephone_number": "401-737-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNENSMITH",
        "first_name": "MARK",
        "middle_name": "REX",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400090284",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206947",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3680",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.