Individual provider Active NPI

Mark Mantell, M.D.

  • Vascular Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1104984046
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD047966L Issued in PA
Practice address
51 N. 39TH Street
Heart & Vascular Pavilion 4TH Floor
Philadelphia, PA 19104-2640
Phone
(215) 662-9551
Fax
(215) 243-3225
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD047966L PA Primary

Addresses

Primary practice location

51 N. 39TH Street
Heart & Vascular Pavilion 4TH Floor
Philadelphia, PA 19104-2640

Mailing address

PO Box 416147
Boston, MA 02241-6147
Phone (610) 644-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140109001458 PA Practitioner - Vascular Surgery 8123058351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Perelman School of Med at the University of Pennsylvania, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Access Care of SP LLCGroup PAC ID 2365411469, 6 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9551

Hospital & facility affiliations

  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Merit-based Incentive Payment System (MIPS)

Final score
74.53 of 100Reported as group
Quality
67.3
Promoting interoperability
87
Improvement activities
40
Cost
25.28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Access Care of SP LLC CurrentSince Apr 1, 2024 Accepting new patients
American Access Care of Pennsylvania LLC CurrentSince Aug 1, 2025 Accepting new patients
American Access Care of Pennsylvania LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

7959 Bustleton Ave
Philadelphia, PA 19152
Phone (215) 742-5662

2412 W Passyunk Ave
Ste 14
Philadelphia, PA 19145
Phone (215) 462-2100

2412 W Passyunk Ave
#14
Philadelphia, PA 19145
Phone (215) 462-2100

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

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.

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1104984046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416147",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416147",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N. 39TH STREET",
            "address_2": "HEART & VASCULAR PAVILION 4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9551",
            "fax_number": "215-243-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELL",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD047966L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.