Individual provider Active NPI

Maila Marie Mantila, NP-C

  • Primary Care Nurse Practitioner
  • Holmdel, NJ
National Provider Identifier
1316765266
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ15133600 Issued in NJ
Practice address
23 Main St Ste D1
Holmdel, NJ 07733-2136
Phone
(732) 571-1000
NPI assigned
Sep 30, 2024
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ15133600 NJ Primary

Addresses

Primary practice location

23 Main St Ste D1
Holmdel, NJ 07733-2136

Mailing address

2 Marlin CT
Jackson, NJ 08527-4859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241202000782 NJ Practitioner - Nurse Practitioner 5496280331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VPS Medical Services, PCGroup PAC ID 2961836069, 45 clinicians

Practice addresses (Care Compare)

3600 State Route 66
FL 4
Neptune, NJ 07753-2645
Phone (732) 571-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15133600NJMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VPS Medical Services, PC CurrentSince Oct 14, 2024 Accepting new patients

Locations

23 Main St
#D1
Holmdel, NJ 07733
Phone (732) 224-6914

3600 State Route 66
Fl 4
Tinton Falls, NJ 07753
Phone (732) 241-4194

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: maila.mantila.p2@direct.vnahg.nextgenshare.com

Organizations & group practices 1

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 3

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1316765266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MARLIN CT",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MAIN ST STE D1",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332136",
            "telephone_number": "732-571-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTILA",
        "first_name": "MAILA",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ15133600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.