Fanny Mantilla

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

212807 Issued in NY

Practice address

4422 3Rd Ave
Care of ER Department
Bronx, NY 10457-2545

Phone

(718) 960-6103

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Emergency MedicineAlso: Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Barnabas Hospital Hospital, Bronx, NY, CCN 330399

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: fmantilla19045@sbhny.direct-ci.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.

• SBH Physicians, PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1740595917

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• SBH Physicians, PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1457665937
  NPD
• Metro Dermatology of Ny,PC

  • Physician Assistant
  • Flushing, NY
  • NPI 1336343268
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Barnabas Hospital

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1548367873
  Care Compare affiliation

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1568416980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "address_2": "CARE OF ER DEPARTMENT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "address_2": "CARE OF ER DEPARTMENT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTILLA",
        "first_name": "FANNY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "212807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02321259",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adriana Manta, M.D.
• Adjoa Mante
• Ginny Mantello, MD
• Anna Mantikas
• Esperanza Mantilla Rivas
• Emma Mantoani, LMSW
• Cornelia Viveca Mantock
• Aneesha Mantripragada, DDS
• Eleni Marie Mantzaris, OTR/L
• Ioannis Mantzaris, M.D

• Emergency Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.