IASON S MANTAGOS (M.D.) – Ophthalmology Physician, NPI 1720255482

IASON S MANTAGOS (M.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in Ophthalmology Physician. They hold the professional credentials M.D.. They hold a License No. 234820 (MA). The NPI Number for IASON S MANTAGOS (M.D.) is 1720255482

Main info

Male
Name
IASON S MANTAGOS (M.D.)
NPI
1720255482
Phone
(617) 355-6401
Address
300 LONGWOOD AVE
Enumeration Date
13 May 2008
Last Update Date
29 April 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for IASON S MANTAGOS (M.D.)

  • Children's Hospital Library, 300, Longwood Avenue, Roxbury, Boston, Suffolk County, Massachusetts, 02120, United States

    FEGAN 4

    BOSTON, MA 02115

    Phone: (617) 355-6401

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $370.

Total Amount is formed as General ($370) + Research ($0) + Ownership ($0) = $370.

Last reported payment date: 2023-07-10 • Largest payer in this snapshot: BIOTISSUE HOLDINGS, INC. ($370).

Total Amount

$370

General + Research + Ownership

Payments

4

Total payment records

General Amount

$370

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
BIOTISSUE HOLDINGS, INC.$370
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: 2009-06-26

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
I20090626000251IOphthalmologyMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02115)

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Reviews

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Frequently asked questions

Is IASON S MANTAGOS (M.D.) listed with a National Provider Identifier?
Yes — IASON S MANTAGOS (M.D.) has NPI 1720255482 on file in the registry.
Would IASON S MANTAGOS (M.D.) appear as active to a payer?
You can treat IASON S MANTAGOS (M.D.) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is IASON S MANTAGOS (M.D.)?
IASON S MANTAGOS (M.D.) is associated with Ophthalmology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is IASON S MANTAGOS (M.D.) located near Boston?
IASON S MANTAGOS (M.D.) currently maps to Boston, Massachusetts in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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