NPIMap

Organization Active NPI

Advanced Manuel Therapy Institute 1 LLC

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1801086053
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1735 Issued in NV
Legal business name
ADVANCED MANUEL THERAPY INSTITUTE 1 LLC
Practice address
911 N Buffalo Dr
#107
Las Vegas, NV 89128-0379
Phone
(702) 896-0383
Fax
(702) 889-0383
NPI assigned
Jul 25, 2007
Last updated
Jun 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Authorized official

Name
Mr. Michel S Rantissi Jr., DPT, MOT, MTCNPI 1912051632
Title
Owner
Phone
(702) 896-0383

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1735 NV Primary
Physical Therapist 225100000X 1719 NV
Occupational Therapist 225X00000X 0662 NV
Occupational Therapist 225X00000X 0663 NV

Addresses

Primary practice location

911 N Buffalo Dr
#107
Las Vegas, NV 89128-0379

Mailing address

2625 W Horizon Ridge Pkwy
#120
Henderson, NV 89052-2896
Phone (702) 896-0383

Other identifiers 5

IdentifierTypeStateIssuer
V101391OtherNVPTAN
V101393OtherNVPTAN
V101389OtherNVPTAN
V101392OtherNVPTAN
V101390OtherNVPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090617000312 NV Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7810922622 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; North Las Vegas, NV; Henderson, NV

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Advanced Manuel Therapy Institute 1 LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1801086053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W HORIZON RIDGE PKWY",
            "address_2": "#120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522896",
            "telephone_number": "702-896-0383",
            "fax_number": "702-889-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N BUFFALO DR",
            "address_2": "#107",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280379",
            "telephone_number": "702-896-0383",
            "fax_number": "702-889-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MANUEL THERAPY INSTITUTE 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "RANTISSI",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-896-0383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPT, MOT, MTC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1735",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1719",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "0662",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "0663",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101391",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101393",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101389",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101392",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "V101390",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.