Patient Resources

a health insurance form

Accepted Insurance

We offer flexible payment options with out-of-pocket fees and convenient pre-paid packages to suit your preferences.

We accept most other major medical insurance plans. We will however, accept out-of network benefits should your insurance carrier offer this benefit.

If you do not see your insurance company listed or are not sure if we accept you type of plan, please give us a call and we will be glad to take your information and verify your physical therapy benefits with us.

  • 1199
  • Aetna
  • Anthem BCBS
  • AmeriHealth Health Plan
  • Blue Cross / Blue Shield
  • Cigna
  • Horizon BCBS
  • Medicare
  • Multiplan
  • NYF D/NYPD
  • No Fault
  • Oxford
  • United Healthcare
  • Worker’s Compensation
Tsahi (Zack) Niv, D.P.T., M.T.C

Aetna | #2298582

Oxford | #P2195022

BC/BS | #QA6161

Medicare | #QA6161

Anthem | #080013973NY01

United Healthcare | #2028059

Cigna | #IS4539068

New Patient Form

Enhance your experience with us by filling out the new patient form. Our team at Manhattan Sports & Manual Physical Therapy looks forward to getting to know you better and providing personalized care!

Functional Assessment

Our spacious modern loft is conveniently located on 33rd Street, between Fifth and Madison Avenue. Our facility includes four comfortable and private treatment rooms equipped with the most advanced therapeutic equipment and modalities.

  • + Back / Spine
  • + Neck NDI
  • + Shoulder / Arm / Hands
  • + Knees / Legs / Hip
+ Back / Spine

OSWESTRY | Back/Spine

This questionnaire has been designed to give us information as to how your back or leg pain is affecting your ability to manage in everyday life. Please answer by checking ONE box in each section for the statement which best applies to you. We realise you may consider that two or more statements in any one section apply but please just shade out the spot that indicates the statement which most clearly describes your problem.

+ Neck NDI

Neck Disability Index | Neck / TMJ / Headaches

This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Please answer every section and mark in each section only the one box that applies to you. We realise you may consider that two or more statements in any one section relate to you, but please just mark the box that most closely describes your problem.

+ Shoulder / Arm / Hands

DASH | Shoulder / Arm / Hands

Please rate your ability to do the following activities in the last week by checking the number below the appropriate response.

+ Knees / Legs / Hip

LEFS | Knees / Legs / Hip

We are interested in knowing whether you are having any difficulty at all with the activities listed below because of your lower limb problem for which you are currently seeking attention. Please provide an answer for each activity. Today, do you or would you have any difficulty at all with.