Individual provider Active NPI

Simon Mantha, MD

  • Hematology (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1831131325
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
229237 Issued in MA
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2000
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 229237 MA Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

633 3Rd Ave
New York, NY 10017-6706
Phone (212) 639-2000

Other identifiers 1

IdentifierTypeStateIssuer
110073774AMedicaidMA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000216 NY Practitioner - HematologyPractitioner - Internal Medicine 1759394307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

530 E 74TH St
New York, NY 10021-3402
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.57 of 100Reported as group
Quality
70.48
Improvement activities
40
Cost
69.36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hematology Lymphoma Group CurrentSince Aug 13, 2012 Accepting new patients
Memorial Hematology Lymphoma Group Hematology CurrentSince Aug 13, 2012 Accepting new patients
Lahey Clinic, Inc. Past Accepting new patients
Lahey Clinic, Inc Past Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

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

Interoperability endpoints

  • Direct secure messaging: smantha40614@mskcc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1831131325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706",
            "telephone_number": "212-639-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTHA",
        "first_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MA",
            "license": "229237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110073774A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.