Individual provider Active NPI

Jessica Mantella, PA-C

  • Medical Physician Assistant
  • Gibsonia, PA
National Provider Identifier
1710282702
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054625 Issued in PA
Practice address
5321 William Flynn Highway
Gibsonia, PA 15044
Phone
(724) 449-9300
NPI assigned
Jan 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054625 PA Primary

Addresses

Primary practice location

5321 William Flynn Highway
Gibsonia, PA 15044

Mailing address

5321 William Flynn Highway
Gibsonia, PA 15044
Phone (724) 449-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA054625PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Community Pediatrics Past Accepting new patients
Children'S Community Care Past Accepting new patients
Children'S Community Care PastSince May 10, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessica.a.mantella@upmcdirect.com

Organizations & group practices 3

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": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1710282702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 WILLIAM FLYNN HIGHWAY",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "15044",
            "telephone_number": "724-449-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5321 WILLIAM FLYNN HIGHWAY",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "15044",
            "telephone_number": "724-449-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELLA",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.