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, and ordering and referring status from the CMS PECOS system.
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.
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.
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
- **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
---
Source: [NPI Profile](https://npiprofile.com/npi/1629069059) · Data from the CMS NPPES public registry.