Manthana Phothisatean, PT, DPT
NPI 1417541889ActiveIndividual· Physical Therapist· New City, NY
Physical Therapist (PT, DPT) with Sports Physical Therapy Occupational Therapy and Rehabilitation Servic, practicing in New City, New York. Medicare paid $29,517 for services to 60 patients in 2024.
Overview
| NPI | 1417541889 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Feb 25, 2021 |
| Last updated in NPPES | Mar 7, 2024 |
| Certified by provider | Mar 7, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 052136 | NY |
| Physical Therapy Assistant | 225200000X | 011579 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 60 |
|---|---|
| Services billed | 1,248 across 9 procedure codes |
| Paid by Medicare | $29,517 |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Sports Physical Therapy Occupational Therapy and Rehabilitation ServicRego Park, NY · 527 clinicians
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