DINA K MANTIS (PA) – Surgical Physician Assistant, NPI 1720289853
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for DINA K MANTIS (PA)
Evanston Hospital, 2650, Ridge Avenue, Evanston, Evanston Township, Cook County, Illinois, 60201, United States
EVANSTON HOSPITAL
EVANSTON, IL 602011718
Phone: (847) 570-1206
Fax: (847) 570-1248
Type: Mailing
Glenbrook Hospital, 2100, Pfingsten Road, Glenview, Northfield Township, Cook County, Illinois, 60026, United States
GLENBROOK HOSPITAL
GLENVIEW, IL 600261301
Phone: (847) 657-5815
Fax: (847) 657-1937
Type: Location
2650 RIDGE AVE # 1223
EVANSTON, IL 602011700
Phone: (847) 982-3175
Fax: (847) 982-3394
Type: Mailing
9600 GROSS POINT RD
SKOKIE, IL 600761214
Phone: (847) 933-6550
Fax: (847) 933-6260
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2023-08-24 • Largest payer in this snapshot: Boston Scientific Corporation ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-04-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120405000733 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| N E U R O L O G Y | IL | |
| Hospitalist, Internal Medicine | IL | |
| O P H T H A L M O L O G Y | IL | |
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IL | |
| Clinical Social Worker | IL | |
| Certified Nurse Midwife (Cnm) | IL |
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