Individual provider Active NPI

Michael T. Mantello

  • Diagnostic Radiology Physician
  • Staten Island, NY
National Provider Identifier
1457338899
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
189156 Issued in NY
Practice address
360 Bard Ave
Staten Island, NY 10310-1666
Phone
(718) 876-2000
NPI assigned
Dec 28, 2005
Last updated
May 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 189156 NY Primary

Addresses

Primary practice location

360 Bard Ave
Staten Island, NY 10310-1666

Mailing address

360 Bard Ave
Staten Island, NY 10310-1666

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmantello90401@nyumc.direct-ci.com Other NYU Langone
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040713000992 NY Practitioner - Diagnostic Radiology 1052399243 Reassigns benefits to 2 organizations
I20251218000716 FL Practitioner - Diagnostic Radiology 1052399243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

150 E 32ND St
New York, NY 10016-6058
Phone (212) 263-3049

1530 Front St
East Meadow, NY 11554-2265
Phone (516) 324-7500

159 E 53Rd St
New York, NY 10022-4602
Phone (646) 754-3300

16244 S Military TRL
560 NYU Langone Cardiology Delray Bea
Delray Beach, FL 33484-6532
Phone (561) 495-7787

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

2318 31St St
Suite 200
Astoria, NY 11105-2765
Phone (718) 777-7742

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

6915 Austin St
Forest Hills, NY 11375-4255
Phone (718) 544-5100

74 Kent St
Brooklyn, NY 11222-1517
Phone (516) 365-4949

77 Medford Ave
Patchogue, NY 11772-1281
Phone (631) 758-1910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
189156NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Mar 13, 2014 Accepting new patients
New York University CurrentSince Mar 13, 2014 Accepting new patients

Locations

16244 S Military Trl
Ste 560
Delray Beach, FL 33484
Phone (561) 495-7787

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: mmantello90401@nyumc.direct-ci.com

Organizations & group practices 2

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 7

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1457338899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELLO",
        "first_name": "MICHAEL",
        "middle_name": "T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "189156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmantello90401@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "address_1": "360 Bard Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103101666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.