SURENDRANATH MANTENA MD
NPI 1629172184
Internal Medicine in Bridgeport, CT

Q: What is Surendranath Mantena's NPI number?

The NPI number for Surendranath Mantena is 1629172184. It was assigned to this individual provider in the NPPES registry on September 12, 2006.

Q: What is Surendranath Mantena's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since September 12, 2006PECOS Enrolled

267 GRANT ST, BRIDGEPORT, CT 06610(203) 688-4748 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Surendranath Mantena Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SURENDRANATH MANTENA MD (NPI 1629172184) is an individual internal medicine provider in Bridgeport, Connecticut, licensed in Connecticut (79241) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Sinai Hospital Of Baltimore, and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1629172184

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSURENDRANATH MANTENACredential: MD

Location Address267 GRANT STBridgeport, CT 06610-2870

Mailing Address267 Grant StBridgeport, CT 06610-2870

Phone(203) 688-4748

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateSeptember 12, 2006

Last NPPES UpdateSeptember 4, 2024

NPPES CertifiedSeptember 4, 2024

✔ NPI 1629172184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in CT · 79241✔ Licensed in IN · 01062267A

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

267 GRANT ST, Bridgeport, CT 06610

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Secondary Practice Location 1

Location 11002 Wishard Blvd, 4th FlIndianapolis, IN 46202-2872 · Phone (317) 692-2323 · Fax (317) 656-3967

Other Identifiers 1

Medicaid200834960IN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Surendranath Mantena Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214039304

PECOS Enrollment IDI20240916003317, I20251215000729

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Surendranath Mantena reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northeast Medical Group, Inc.

0.1 mi

Internal Medicine

226 MILL HILL AVENUE, 3RD FLR
Bridgeport, CT 06610

Reassigned Medicare billing, Connecticut enrollment
1,824 clinicians in this Medicare group

NPI 1043278351 (203) 384-3975

Sinai Hospital Of Baltimore Inc

219 mi

Infectious Disease

849 FAIRMOUNT AVE STE 100B
Towson, MD 21286

Reassigned Medicare billing, Maryland enrollment
664 clinicians in this Medicare group

NPI 1669182499 (410) 601-9000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sinai Hospital Of Baltimore

Acute Care Hospitals · Baltimore, MD

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210012

Location2401 West Belvedere AvenueBaltimore, MD 21215 · Baltimore City County

Emergency services Birthing friendly

Levindale Hebrew Geriatric Center And Hospital

Acute Care Hospitals · Baltimore, MD

OwnershipVoluntary non-profit - Private

CMS Certification Number210064

Location2434 West Belvedere AvenueBaltimore, MD 21209 · Baltimore City County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06610 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.84 typical visit price

range $60.82 – $183.10

Typical copayment $34.71 (range $15.20 – $45.77)

Most-billed visit code 99204

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MR. ALEX SCOTT CADAN PA-C

Physician Assistant (Surgical)