Individual provider Active NPI

Isabel Mantooth, PA-C

  • Physician Assistant
  • Round Rock, TX
National Provider Identifier
1073148300
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone
(512) 341-1000
NPI assigned
Mar 6, 2020
Last updated
Nov 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X PA13478 TX

Addresses

Primary practice location

2400 Round Rock Ave
Round Rock, TX 78681-4004

Mailing address

4224 Dutchman Dr
Pflugerville, TX 78660-6019

Other practice location 1

3110 Guadalupe St Ste 100
Austin, TX 78705-2858
Phone (512) 599-9510

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address imantooth@directorthocare.com Direct Orthopedic Care LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200416000981 TX Practitioner - Physician Assistant 2769812643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. David's Ortho Neuro and Rehab PLLCGroup PAC ID 5799948857, 60 clinicians

Practice addresses (Care Compare)

2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone (512) 341-1000

919 E 32ND St
Austin, TX 78705-2703
Phone (412) 476-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctx3 PLLC Sports Medicine CurrentSince Mar 16, 2020 Accepting new patients
Doctx3 PLLC Sports Medicine CurrentSince Mar 16, 2020 Accepting new patients
Neurotexas, PLLC Past Accepting new patients

Locations

3110 Guadalupe St
Ste 100
Austin, TX 78705
Phone (512) 599-9510

709 E Slaughter Ln
Ste 404
Austin, TX 78744
Phone (512) 277-6643

9500 Dallas Pkwy
Ste 100
Frisco, TX 75033
Phone (469) 535-6647

3014 N O Connor Rd
Ste 200
Irving, TX 75062
Phone (214) 444-5558

2000 S Interstate 35
Ste N5
Round Rock, TX 78681
Phone (512) 244-3822

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1073148300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 DUTCHMAN DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786606019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814004",
            "telephone_number": "512-341-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3110 Guadalupe St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787052858",
            "country_code": "US",
            "telephone_number": "512-599-9510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTOOTH",
        "first_name": "ISABEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "PA13478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imantooth@directorthocare.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Direct Orthopedic Care LLC",
            "address_1": "2000 S IH 35 Frontage Rd",
            "address_2": "Suite N5",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.