Kelly Mantia, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

352247 Issued in NY

Practice address

650 Central Ave
Cedarhurst, NY 11516-2301

Phone

(516) 340-0702

NPI assigned

Jun 21, 2023

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

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 Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1396794574
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1679258222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 OCEAN AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622323",
            "telephone_number": "718-812-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162301",
            "telephone_number": "516-340-0702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Massapequa Park",
            "state": "NY",
            "postal_code": "117622323",
            "country_code": "US",
            "telephone_number": "718-812-4774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTIA",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yehudis Lovett, NP
• Simona Lumerman, PSY.D.
• Karen Mackler, PH.D.
• Nicolette Makedon, LMHC
• Randy Malek Hackel
• Michelle Marciano, MS. C-C-C SLP
• Stephen H Marcus, MD
• Michael E. Margulis, M.D.
• Mark M. Bornstein, DDS, PLLC
• David Mark

• Family Nurse Practitioner in Cedarhurst, NY
• Providers in Cedarhurst, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.