Holly Manchester

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

014616-01 Issued in NY

Practice address

810 W Genesee Street Rd
Skaneateles, NY 13152-9311

Phone

(315) 291-7042

NPI assigned

Apr 8, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Shelly Kraetz

  dba FYZICAL Therapy & Balance Centers

  • Physical Therapy Clinic/Center
  • Skaneateles, NY
  • NPI 1730463134
  NPD

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1841084456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W GENESEE STREET RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W GENESEE STREET RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529311",
            "telephone_number": "315-291-7042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5639 W Genesee St",
            "address_purpose": "LOCATION",
            "city": "Camillus",
            "state": "NY",
            "postal_code": "130311250",
            "country_code": "US",
            "telephone_number": "315-565-7060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014616-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Elise Loudon, RPH
• Erin Maureen Macdonald
• Lauren M. Macdonald, PT
• Bridget Mahoney
• Olivia Mancabelli, MA, RDN
• Marc P Pietropaoli MD PC (Victory Sports Medicine & Orthopedics)
• Bader Masoud, PHYSICIAN ASSISTANT
• John J Maurillo Jr., O.D.
• Arianna Elysse Mejias, MS, RD, LDN
• Melissa M Kallfelz Choosing Change Counseling Service

• Physical Therapy Assistant in Skaneateles, NY
• Providers in Skaneateles, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.