Esteban Guillermo Mantilla Rodriguez, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0007102 Issued in MD

Practice address

8401 Connecticut Ave PH Suite
Chevy Chase, MD 20815-5822

Phone

(301) 942-2212

NPI assigned

Jun 27, 2019

Last updated

Sep 24, 2020By the provider in NPPES

Sex

Male

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 DC

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

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

One Medstar Primary Care LLCGroup PAC ID 0749607307, 140 clinicians

Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• One Medstar Primary Care LLC

  • Family Medicine Physician
  • Washington, DC
  • NPI 1417571530
  Medicare reassignment Care Compare group
• Suburban/NRH Medical Rehabilitation Inc

  dba NRH Rehabilitation Network at Bethesda

  • Rehabilitation Clinic/Center
  • Bethesda, MD
  • NPI 1457354748
  Care Compare group
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1851952089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE PH SUITE",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155822",
            "telephone_number": "301-942-2212",
            "fax_number": "301-942-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE PH SUITE",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155822",
            "telephone_number": "301-942-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19735 Germantown Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208741225",
            "country_code": "US",
            "telephone_number": "301-942-2212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTILLA RODRIGUEZ",
        "first_name": "ESTEBAN",
        "middle_name": "GUILLERMO",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Leslie Mallory-Powell, PH.D.
• Danielle Mandir
• Keon B. Manesh, DDS, MS
• Manor Care of Chevy Chase MD, LLC (ProMedica Skilled Nursing and Rehabilitation (Chevy Chase))
• Alix L Mansbach, PSY.D.
• Anand Mantravadi, M.D.
• Robert L. Mapou, PH.D.
• Margaret Reba Stevens Oneill MD, LLC
• Elizabeth Margiotta, PT
• Elizabeth Stacy Margolies, PT

• Physician Assistant in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.
• 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.