Individual provider Active NPI

Maureen Mantin, PA

  • Physician Assistant
  • Westerville, OH
National Provider Identifier
1730133687
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2317 Issued in OH
Practice address
460 Polaris Pkwy Ste 200
Westerville, OH 43082-8213
Phone
(614) 865-3125
Fax
(614) 273-0520
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2317 OH Primary

Addresses

Primary practice location

460 Polaris Pkwy Ste 200
Westerville, OH 43082-8213

Mailing address

460 Polaris Pkwy Ste 200
Westerville, OH 43082-8213
Phone (614) 865-3125

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050907000654 OH Practitioner - Physician Assistant 5496787723 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1953

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2317OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2022 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Physician Assistant CurrentSince Dec 16, 2024 Accepting new patients
Emergency Professionals of Ohio, Inc. Physician Assistant Past Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

460 Polaris Pkwy
Ste 200
Westerville, OH 43082
Phone (614) 797-0547

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: mmantin81727@copcp.medicity.net

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1730133687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 POLARIS PKWY STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828213",
            "telephone_number": "614-865-3125",
            "fax_number": "614-273-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 POLARIS PKWY STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828213",
            "telephone_number": "614-865-3125",
            "fax_number": "614-273-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTIN",
        "first_name": "MAUREEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "2317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.