Active NPI
Mancini Physical Therapy, PC
- Physical Therapist
- Deer Park, NY
National Provider Identifier
1891217899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020597
- Legal business name
- MANCINI PHYSICAL THERAPY, PC
- Practice address
- 375 Commack Rd Ste B
Deer Park, NY 11729-5515 - Phone
- (516) 318-8556
- NPI assigned
- Jul 11, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Mancini, MSPT
- Title
- Owner/Physical Therapist
- Phone
- (631) 522-1955
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 020597 | Primary |
Addresses
Primary practice location
375 Commack Rd Ste B
Deer Park, NY 11729-5515
Mailing address
375 Commack Rd Ste B
Deer Park, NY 11729-5515
Phone (631) 522-1955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170828000613 | NY | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3072885904 |
Receives reassigned benefits from 2 practitioners Practice locations: Deer Park, NY |
National Provider Directory
National Provider DirectoryLocations
375 Commack Rd
Ste B
Deer Park, NY 11729
Phone (516) 318-8556
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Centereach, NY
- NPI 1780356956
NY, Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1891217899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 COMMACK RD STE B",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117295515",
"telephone_number": "631-522-1955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 COMMACK RD STE B",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117295515",
"telephone_number": "516-318-8556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MANCINI PHYSICAL THERAPY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-11",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "MANCINI",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
"authorized_official_telephone_number": "631-522-1955",
"authorized_official_credential": "MSPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": "020597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.