David W. Mantik, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

G34416 Issued in CA

Practice address

963 Butte St
Redding, CA 96001-0828

Phone

(530) 245-5900

Fax

(530) 245-5909

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

State licenses

Practice roles

Locations

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.

• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1972569820
  Medicare reassignment NPD
• Genesiscare USA of California a Medical Corporation

  • Radiation Oncology Physician
  • Palm Desert, CA
  • NPI 1861472318
  NPD (past)
• Genesiscare USA of California a Medical Corporation

  • Radiation Oncology Physician
  • Modesto, CA
  • NPI 1881624583
  NPD (past)
• J Robert West, M.D., Inc

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788
  NPD (past)
• Shared Magnetic Resonance Imaging Facility, Inc

  • Radiation Oncology Clinic/Center
  • Madison, WI
  • NPI 1780640532
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1669421012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 BUTTE ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010828",
            "telephone_number": "530-245-5900",
            "fax_number": "530-245-5909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Hal Greer Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257014114",
            "country_code": "US",
            "telephone_number": "304-399-6610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTIK",
        "first_name": "DAVID",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WV",
            "license": "25351",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G34416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G344161",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00763965",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Mann
• Keith Dean Manner, M.S.
• Charles Everett Mansell, MD
• Olivia A Mansilla, MD
• Dorinda Elaine Manson, NURSE LVN 83466
• Dinesh S Mantri, MD
• Soledad Hernandez Manzo
• Cameron Mapes, LPCC
• Courtney Danielle Mapes
• Richard M Maples, M.D.

• Radiation Oncology Physician in Redding, CA
• Providers in Redding, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.