Individual provider Active NPI

Christopher M Mantik, MD

  • Physical Medicine & Rehabilitation Physician
  • Redlands, CA
National Provider Identifier
1053971978
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A183549 Issued in CA
Practice address
1901 W Lugonia Ave Ste 230
Redlands, CA 92374-9705
Phone
(909) 557-1600
Fax
(909) 557-1740
NPI assigned
Jun 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X A183549 CA Primary

Addresses

Primary practice location

1901 W Lugonia Ave Ste 230
Redlands, CA 92374-9705

Mailing address

1801 Orange Tree LN Ste 200
Redlands, CA 92374-4587
Phone (909) 557-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240507002002 CA Practitioner - Physical Medicine and Rehabilitation 8426482530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Pittsburgh School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1901 W Lugonia Ave
Suite 120 130
Redlands, CA 92374-9703
Phone (909) 557-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A183549CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Past Accepting new patients

Locations

3889 W Stetson Ave
Ste 100
Hemet, CA 92545
Phone (951) 652-1600

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

1901 W Lugonia Ave
Ste 230
Redlands, CA 92374
Phone (909) 557-1607

1901 W Lugonia Ave
Ste 120
Redlands, CA 92374
Phone (909) 557-1626

1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607

1801 Orange Tree Ln
Ste 240
Redlands, CA 92374

2131 Elks Dr
Ste 200
San Bernardino, CA 92404
Phone (909) 726-6100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1053971978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ORANGE TREE LN STE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744587",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 230",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749705",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTIK",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A183549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.