Individual provider Active NPI

Jose Oscar Mantilla-Rivas

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1619458676
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD477620 Issued in PA
Practice address
6501 Arlington Expressway
B105#7069
Jacksonville, FL 32211-5779
Phone
(904) 201-9110
Fax
(757) 432-3134
NPI assigned
Aug 27, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC009876 PA
Student in an Organized Health Care Education/Training Program 390200000X MT215100 PA
Psychiatry Physician 2084P0800X MD477620 PA Primary

Addresses

Primary practice location

6501 Arlington Expressway
B105#7069
Jacksonville, FL 32211-5779

Mailing address

6501 Arlington Expressway
B105#7069
Jacksonville, FL 32211
Phone (904) 201-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20230613002409 PA Practitioner - Psychiatry 7113384785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD477620PAMDPsychiatry Physician
MT215100PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Professional CurrentSince Jul 19, 2023 Accepting new patients
Psychiatry by Mantilla-Rivas Current Accepting new patients
Jefferson Regional Medical Center Professional CurrentSince Jul 1, 2024 Accepting new patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Jul 19, 2023 Accepting new patients
Jefferson Regional Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

565 N Lewis Run Rd
Jefferson Hills, PA 15025
Phone (412) 469-3200

4 Allegheny Ctr
Fl 7
Pittsburgh, PA 15212

4 Allegheny Ctr
Fl 8
Pittsburgh, PA 15212
Phone (412) 330-4242

810 Clairton Blvd
Pleasant Hills, PA 15236
Phone (412) 466-5004

701 Broad St
Ste 431
Sewickley, PA 15143
Phone (412) 741-0966

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1619458676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 ARLINGTON EXPRESSWAY",
            "address_2": "B105#7069",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32211",
            "telephone_number": "904-201-9110",
            "fax_number": "757-432-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 ARLINGTON EXPRESSWAY",
            "address_2": "B105#7069",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115779",
            "telephone_number": "904-201-9110",
            "fax_number": "757-432-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTILLA-RIVAS",
        "first_name": "JOSE",
        "middle_name": "OSCAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC009876",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT215100",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD477620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.