TATIANA MARIE MAMANTOV MD
NPI 1629069059
Emergency Medicine in Castro Valley, CA
About Tatiana Marie Mamantov Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TATIANA MARIE MAMANTOV MD (NPI 1629069059) is an individual emergency medicine provider in Castro Valley, California, licensed in California (G85179) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS and is a graduate of East Tennessee State University Quillen College Of Medicine (1984).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tatiana Marie Mamantov Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Tatiana Mamantov reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Francisco, CA 94143
- Reassigned Medicare billing, California enrollment
- 637 clinicians in this Medicare group
San Diego, CA 92111
- Reassigned Medicare billing, California enrollment
- 1,233 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tatiana Mamantov's NPI number?
The NPI number for Tatiana Mamantov is 1629069059. It was assigned to this individual provider in the NPPES registry on November 3, 2005.
Where is Tatiana Mamantov located?
Tatiana Mamantov practices at 20103 Lake Chabot Rd, Castro Valley, CA 94546. The listed phone number is (209) 342-2300.
What is Tatiana Mamantov's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Tatiana Mamantov enrolled in Medicare?
Yes. Tatiana Mamantov is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Tatiana Mamantov's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tatiana Mamantov reassigns Medicare benefits to 2 organizations: University Of California Sfgh Medical Group (San Francisco, CA) and Sharp Rees-Stealy Medical Group, Inc (San Diego, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tatiana Mamantov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Tatiana Mamantov was last updated on July 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tatiana Marie Mamantov, MD · NPI 1629069059
Emergency Medicine physician in Castro Valley, California. Individual provider, active in the CMS NPPES registry since November 3, 2005.
## Identity
- **NPI:** 1629069059 (Entity type: Individual)
- **Enumerated:** November 3, 2005
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** G85179 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 20103 LAKE CHABOT RD, Castro Valley, CA 94546-5341
- **Phone:** (209) 342-2300 · **Fax:** (209) 524-4240
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): University Of California Sfgh Medical Group (NPI 1265407381, San Francisco, CA); Sharp Rees-Stealy Medical Group, Inc (NPI 1285616177, San Diego, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** East Tennessee State University Quillen College Of Medicine, class of 1984
## Record status
- **NPPES last updated:** July 30, 2008
- **Other identifiers:** Medicare PIN 00G851794 (CA); Medicare UPIN E38695; Other 00G851790 (CA); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1629069059) · Data from the CMS NPPES public registry.