ANGEL RENEE MANTAY (AGACNP-BC) – Acute Care Nurse Practitioner, NPI 1194238972
Acute Care Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ANGEL RENEE MANTAY (AGACNP-BC)
2790 Godwin Blvd Ste 205
Suffolk, VA 234348154
Phone: (757) 942-2566
Type: Location
1020 First Colonial Rd Ste A
Virginia Beach, VA 23454
Phone: (757) 395-1850
Type: Location
First Colonial Road, Virginia Beach, Virginia, 23454, United States
VIRGINIA BEACH, VA 234543002
Phone: (757) 395-1850
Type: Mailing
2800 GODWIN BLVD FL 1
SUFFOLK, VA 234348038
Phone: (757) 934-4821
Fax: (757) 934-4276
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-03-05
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 |
|---|---|---|---|---|
| I20180305000268 | I | Nurse Practitioner | VA | 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 23434)
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