NPIMap

Individual provider Active NPI

Eric P Mantz, M.D.

  • Surgery Physician
  • Charleston, WV
National Provider Identifier
1215023064
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
09636 Issued in WV
Practice address
600 Morris St
Suite 103
Charleston, WV 25301-1409
Phone
(304) 388-7040
Fax
(304) 388-7041
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 09636 WV Primary

Addresses

Primary practice location

600 Morris St
Suite 103
Charleston, WV 25301-1409

Mailing address

600 Morris St 103
Charleston, WV 25301-1409
Phone (304) 388-7040

Other identifiers 2

IdentifierTypeStateIssuer
P01106930OtherWVRAILROAD MEDICARE
0127930000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040302000985 WV Practitioner - General Surgery 2264329440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
West Virginia University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Association Dr
Suite 102
Charleston, WV 25311-1298

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

600 Morris St
Charleston, WV 25301-1409

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Dec 1, 2015 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Wvupc-Camc Wound Care Center Past Accepting new patients

Locations

600 Morris St
Ste 103
Charleston, WV 25301
Phone (304) 388-7040

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

3100 Maccorkle Ave SE
Ste 203
Charleston, WV 25304
Phone (304) 345-8820

3100 Maccorkle Ave SE
Ste 504
Charleston, WV 25304
Phone (304) 346-0479

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1215023064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MORRIS ST 103",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011409",
            "telephone_number": "304-388-7040",
            "fax_number": "304-388-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MORRIS ST",
            "address_2": "SUITE 103",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011409",
            "telephone_number": "304-388-7040",
            "fax_number": "304-388-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTZ",
        "first_name": "ERIC",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "09636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01106930",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0127930000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.