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

Mrs. Tara Manzano, OTR/L

Individual provider Occupational Therapist · NPI 1164853255

Mrs. Tara Manzano, OTR/L is registered under Occupational Therapist in Private Practice in Carbondale, Illinois. Qualified in 2001, 25 years ago. Practices with Myofascial Release of Southern Illinois, a 2-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
25
Licensed in
IL
In the registry since
2013
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

101 S Graham Ave Ste 3
Carbondale, IL 62901-3043 Not confirmed with CMS for 11 years — call before visiting
Phone: (618) 305-4696
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 056006377 (IL)

Record details

NPI number1164853255
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedNovember 27, 2013
Last updated in NPPESNovember 4, 2014

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Myofascial Release Of Southern Illinois — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients28
Services billed 2,162 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Myofascial Release of Southern Illinois

Clinicians the CMS Doctors & Clinicians file lists under the same group practice.

Other providers in Carbondale