Active NPI
Madison Bree Mantyla, MD
- Pediatrics Physician
- Lawrenceburg, IN
National Provider Identifier
1548965619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01100308A
- Practice address
- 98 Elm St
Lawrenceburg, IN 47025-2048 - Phone
- (812) 496-8777
- Fax
- (812) 537-9974
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01100308A | IN | Primary |
Addresses
Primary practice location
98 Elm St
Lawrenceburg, IN 47025-2048
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (812) 496-8777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Cincinnati, OH 45263
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782950400000",
"number": "1548965619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635283",
"telephone_number": "812-496-8777",
"fax_number": "812-537-9974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 ELM ST",
"city": "LAWRENCEBURG",
"state": "IN",
"postal_code": "470252048",
"telephone_number": "812-496-8777",
"fax_number": "812-537-9974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTYLA",
"first_name": "MADISON",
"middle_name": "BREE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-30",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01100308A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.