Premalatha Manickam Sr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02086700 Issued in NJ

Practice address

270 US Highway 206 S SPC A114
Chester, NJ 07930-2491

Phone

(908) 888-0441

NPI assigned

Sep 26, 2022

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Trinity Rehab Somerset PAGroup PAC ID 0547540809, 57 clinicians

Practice addresses (Care Compare)

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.

• Sportscare of America, PC

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1851484380
  Medicare reassignment Care Compare group NPD
• Trinity Rehab Somerset PA

  • Physical Therapist
  • Somerset, NJ
  • NPI 1245789064
  Medicare reassignment Care Compare group NPD
• United Sports Care & Physical Therapy

  • Occupational Therapist
  • Cedar Knolls, NJ
  • NPI 1972881233

  Physical Therapist

  Medicare reassignment NPD
• Trinity Rehab Somerset PA

  dba Trinity Rehab Middletown

  • Physical Therapy Clinic/Center
  • Red Bank, NJ
  • NPI 1528580925
  NPD
• Trinity Rehab Somerset PA

  dba Trinity Rehab North Wales PA

  • Physical Therapy Clinic/Center
  • North Wales, PA
  • NPI 1144892852
  NPD
• Trinity Rehab Somerset PA

  dba Trinity Rehab Chester

  • Physical Therapy Clinic/Center
  • Chester, NJ
  • NPI 1568089647
  NPD (past)

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1871216614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 US HIGHWAY 206 S SPC A114",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302491",
            "telephone_number": "908-888-0441",
            "fax_number": "732-289-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 US HIGHWAY 206 S SPC A114",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302491",
            "telephone_number": "908-888-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANICKAM",
        "first_name": "PREMALATHA",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02086700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "premalatha.manickam@trinity-rehab.com",
            "affiliation": "N",
            "address_1": "270 US Highway 206 S Spc A114",
            "city": "Chester",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "079302491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Arline Mahoney
• Jessica Malfa
• Brittany Mallardi, PA-C
• Kaeley Renee Maltez, MS, RDN, LMT
• Rekha J. Mandel, MD
• Danielle Mannino, PT, DPT
• Kathleen Marie Marino, MS CCC/SLP
• Hongmarie Martinez-Carter, PSYD
• Gladys Martinez, RN
• Maryanna Domenic Apn (Domenic Psychiatry)

• Physical Therapist in Chester, NJ
• Providers in Chester, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.