Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Manoj Varughese Elamthottathil, PHYSICALTHERAPIST

Individual provider Physical Therapist · NPI 1265800403

Manoj Varughese Elamthottathil, PHYSICALTHERAPIST is a Physical Therapist in Private Practice in Staten Island, New York. Qualified in 2004, 22 years ago. Accepts Medicare assignment. Licensed in New York.

Years since qualifying
22
Licensed in
NY
In the registry since
2015
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Practice location Address checks out

525 Clove Rd Apt 1G
Staten Island, NY 10310-2312
Phone: (917) 319-5688
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 039449 (NY)

Record details

NPI number1265800403
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICALTHERAPIST
Sole proprietorNo
NPI enumeratedSeptember 4, 2015
Last updated in NPPESSeptember 4, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Staten Island