Augustus G Mantia, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

124142 Issued in NY

Practice address

59 Southern Blvd
Nesconset, NY 11767-1090

Phone

(631) 659-1700

Fax

(631) 659-1750

NPI assigned

Jul 11, 2005

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

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.

• North Shore Medical Group of the Mount Sinai School of Medicine

  dba Mount Sinai Doctors Long Island

  • Internal Medicine Physician
  • Greenlawn, NY
  • NPI 1275640609
  Medicare reassignment NPD
• Mantia Medical Associates

  • Family Medicine Physician
  • Smithtown, NY
  • NPI 1477629400

  Internal Medicine

  NPD (past) Authorized official
• North Shore Medical Group of the Mount Sinai School of Medicine

  dba North Shore Medical Group

  • Gastroenterology Physician
  • Huntington, NY
  • NPI 1164623278
  NPD
• Meadows Nuclear Spect Imaging, PC

  • Nuclear Cardiology Physician
  • Smithtown, NY
  • NPI 1962573592
  NPD (past)
• Nuclear Cardiac and Medical Imaging Services, PC

  • Nuclear Cardiology Physician
  • New York, NY
  • NPI 1902000755
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1588662829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671090",
            "telephone_number": "631-659-1700",
            "fax_number": "631-659-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671090",
            "telephone_number": "631-659-1700",
            "fax_number": "631-659-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTIA",
        "first_name": "AUGUSTUS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "124142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002785973",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Angela Lopez, DNP-FNP
• Lucky Ambulette Services
• Daniel Macari Jr., DDS
• Jamie Mackey, PT
• Jyoti Manchandani, PSY.D
• Marie Care NP in Adult Health P.C
• Helene Markowitz, PT
• Matthew Mattone, MS,APRN,BC-ANP
• Philip Vincent Mazzola, DDS
• Lisa Marie McDevitt, AU.D.

• Internal Medicine Physician in Nesconset, NY
• Providers in Nesconset, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.