DR. MARK MANTELL (M.D.) – Vascular Surgery Physician, NPI 1104984046

DR. MARK MANTELL (M.D.) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in VASCULAR SURGERY. They hold the professional credentials M.D.. They hold a License No. MD047966L (PA). The NPI Number for DR. MARK MANTELL (M.D.) is 1104984046

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK MANTELL (M.D.)
NPI
1104984046
Phone
(215) 893-2996
Address
1800 LOMBARD ST
Enumeration Date
4 December 2006
Last Update Date
13 June 2025

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
2156629551
Graduation Year
1989 (37 years ago)
PAC ID
8123058351
Group Practice PAC ID
2365411469
Professional Enrollment ID
I20140109001458
Address ID
PA191042640PH51XXXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Digital endpointsOther names

371 VASCULAR SURGERY in PA

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Provider Addresses for DR. MARK MANTELL (M.D.)

  • Penn Medicine Rittenhouse, 1800, Lombard Street, Rittenhouse Square, Philadelphia, Philadelphia County, Pennsylvania, 19146, United States

    SUITE 805

    PHILADELPHIA, PA 191468400

    Phone: (215) 893-2996

    Fax: (215) 893-7354

    Type: Mailing

  • PO BOX 416147

    BOSTON, MA 022416147

    Phone: (610) 644-8900

    Fax: (484) 924-0053

    Type: Mailing

  • 51 N. 39TH STREET

    HEART & VASCULAR PAVILION 4TH FLOOR

    PHILADELPHIA, PA 191042640

    Phone: (215) 662-9551

    Fax: (215) 243-3225

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $2,040.

Total Amount is formed as General ($2,040) + Research ($0) + Ownership ($0) = $2,040.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: ETS Wound Care LLC ($2,000).

Total Amount

$2,040

General + Research + Ownership

Payments

2

Total payment records

General Amount

$2,040

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2014-01-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140109001458IVascular SurgeryPATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99212Established patient office or other outpatient visit, 10-19 minutes237146$0
99213Established patient office or other outpatient visit, 20-29 minutes146102$0
99214Established patient office or other outpatient visit, 30-39 minutes6354$0
99204New patient office or other outpatient visit, 45-59 minutes5656$0
36821Relocation of arm vein with connection to arm artery for hemodialysis5147$0
View full utilization report →

Insurance plans in this area (ZIP 19146)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365411469View full group profile
NameSpecialtyState
-PA
-MA
Interventional RadiologyMD
Interventional Radiology, Diagnostic RadiologyPA
Nephrology, Internal Medicine, Interventional Radiology, Interventional Radiology, NephrologyPA
Interventional Radiology, Diagnostic Radiology, Interventional RadiologyNJ
Interventional Radiology, Diagnostic RadiologyMA

Reviews

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Frequently asked questions

What unique ID ties claims to DR. MARK MANTELL (M.D.)?
NPI 1104984046 is assigned to DR. MARK MANTELL (M.D.) under the national enumeration system.
Is DR. MARK MANTELL (M.D.)'s NPI currently valid?
The extract we use shows DR. MARK MANTELL (M.D.) as active.
Does DR. MARK MANTELL (M.D.) list a primary specialty?
If you are matching referrals, note Vascular Surgery Physician for DR. MARK MANTELL (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. MARK MANTELL (M.D.)?
The page summarizes Philadelphia, Pennsylvania for DR. MARK MANTELL (M.D.); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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