Nathalie Mantilla Farfan, M.D

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

101399 Issued in GA

Practice address

1348 Walton Way Ste 6500
Augusta, GA 30901-5111

Phone

(706) 722-2118

NPI assigned

Apr 6, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Nathalie Mantilla Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, GA2 enrollments

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 2

Specialty

Colorectal Surgery (Proctology)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

Merit-based Incentive Payment System (MIPS)

Final score

95.11 of 100Reported as group

Quality

74.7

Promoting interoperability

100

Improvement activities

40

Cost

85.45

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment Care Compare group NPD
• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170

  Surgery

  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD

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

• University Health Services,Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1588665566
  Care Compare affiliation

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1972828671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S MICHIGAN AVE APT 3104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052322",
            "telephone_number": "312-927-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY STE 6500",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015111",
            "telephone_number": "706-722-2118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 W Polk St # 406",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123723",
            "country_code": "US",
            "telephone_number": "312-864-3197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTILLA FARFAN",
        "first_name": "NATHALIE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036140788",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036140788",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "101399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmantilla@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NATHALIE",
            "last_name": "MANTILLA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chelsea Manning
• Meenakumari Manoharan
• Sujitha Manoj, CRNA
• Joshua Mansour, M.D.
• Asifhusen Abdulrahim Mansuri, M.D.
• Mantilla Surgical Colorectal & Pelvic Health
• Many Waters Counseling
• Manvitha Manyam
• Marc Manzo, MD
• Shirley Meas Mao, M.D.

• Colon & Rectal Surgery Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Colon & Rectal Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.