Organization Active NPI

US Rehabilitation Medicine Consulting, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Manhasset, NY
National Provider Identifier
1790504637
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
US REHABILITATION MEDICINE CONSULTING, PLLC
Practice address
1615 Northern Blvd Ste GR4
Manhasset, NY 11030-3008
Phone
(516) 888-7614
NPI assigned
Oct 8, 2024
Last updated
Oct 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
Manish MammenNPI 1588951388
Title
MD
Phone
(516) 888-7614

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1615 Northern Blvd Ste GR4
Manhasset, NY 11030-3008

Mailing address

1615 Northern Blvd Ste GR4
Manhasset, NY 11030-3008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121001598 NY Part B Supplier - Clinic/Group Practice 6204365224 Receives reassigned benefits from 5 practitioners
Practice locations: Manhasset, NY

National Provider Directory

National Provider Directory

Locations

1615 Northern Blvd
#4
Manhasset, NY 11030

1615 Northern Blvd
Ste GR4
Manhasset, NY 11030
Phone (516) 888-7614

Practitioners & affiliated clinicians

Practitioners 5

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": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1790504637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 NORTHERN BLVD STE GR4",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 NORTHERN BLVD STE GR4",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303008",
            "telephone_number": "516-888-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US REHABILITATION MEDICINE CONSULTING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "MAMMEN",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "516-888-7614"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.