Jimmy P Manansala Jr., RPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

5501009386 Issued in MI

Practice address

33620 Five Mile Rd Ste a
Livonia, MI 48154-2866

Phone

(248) 957-8930

Fax

(313) 541-1171

NPI assigned

Feb 29, 2016

Last updated

Aug 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehabcare Connect PLLC

  • Contractor
  • Livonia, MI
  • NPI 1386004612
  Authorized official Same address or phone
• Serenity Hospice Care LLC

  • Community Based Hospice Care Agency
  • Livonia, MI
  • NPI 1356958649
  NPD
• Home Care Connect, Inc.

  • Home Health Agency
  • Livonia, MI
  • NPI 1194951384
  NPD (past)

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1851751192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37100 BAKER DR",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481853766",
            "telephone_number": "248-722-2220",
            "fax_number": "313-741-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33620 FIVE MILE RD STE A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542866",
            "telephone_number": "248-957-8930",
            "fax_number": "313-541-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANANSALA",
        "first_name": "JIMMY",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "5501009386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "5501009386",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Harper Maloney
• Managed Mind Therapy LLC
• Management Strategies Co., Inc (Vivo Center)
• Atilano Manuelito Mendoza Manalese, RPT
• Keianne Mary Manalese
• Mary Manaois
• Adam Mancina, BEHAVIOR TECHNICIAN
• Grace Elizabeth Mancina
• Michael A Mandell, MD
• Fawaz Manfoukh

• Specialist in Livonia, MI
• Providers in Livonia, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.