Jason K Manthei, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

715 Broadway St
Gillespie, IL 62033-1166

Phone

(217) 839-4491

NPI assigned

Jul 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: jasonmanthei@macoupinfm.allscriptsdirect.net

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.

• Macoupin Family Practice Centers LLP

  • Family Medicine Physician
  • Gillespie, IL
  • NPI 1699899070
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1477586121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 BROADWAY ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331166",
            "telephone_number": "217-839-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 BROADWAY ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331166",
            "telephone_number": "217-839-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTHEI",
        "first_name": "JASON",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macoupin County Public Health Department
• Macoupin Family Practice Center, LLP
• Macoupin Family Practice Centers LLP
• Macoupin Family Practice Centers, LLP
• Divya J Makhija
• Neuropathy Center of Gillespie
• Roy Northcutt, DMD
• Jamie J Ott, FNP-C
• Alexis Grace Page
• Jenalen F Parke

• All providers in Gillespie, IL
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.