Mrs Madeline Mantilla, MS in Stamford, CT - Medicare Counselor Provider

Mrs Madeline Mantilla, MS is a medicare enrolled "Counselor - Professional" provider in Stamford, Connecticut. Her current practice location is 401 Shippan Ave, Stamford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 517-3375.

Mrs Madeline Mantilla is licensed to practice in Connecticut (license number 003667) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184004335.

Contact Information

	Mrs Madeline Mantilla, MS
	401 Shippan Ave, Stamford, CT 06902-6075
	(203) 517-3375
	(203) 353-1524

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Madeline Mantilla
Gender	Female
Speciality	Counselor - Professional
Location	401 Shippan Ave, Stamford, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184004335
Provider Enumeration Date: 06/03/2015
Last Update Date: 12/03/2019

Medicare PECOS Information:

PECOS PAC ID: 7315395068
Enrollment ID: I20231227003176

Medical Identifiers

Medical identifiers for Mrs Madeline Mantilla such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184004335	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	003667 (Connecticut)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Madeline Mantilla allows following entities to bill medicare on her behalf.

Entity Name	Community Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952591851 PECOS PAC ID: 0547169138 Enrollment ID: O20040102000412

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Madeline Mantilla is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Madeline Mantilla, MS 180 Fairfield Ave, Bridgeport, CT 06604-4252 Ph: (203) 394-6529	Mrs Madeline Mantilla, MS 401 Shippan Ave, Stamford, CT 06902-6075 Ph: (203) 517-3375

Reviews and Comments

Counselor in Stamford, CT

Brianna Robinson, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 1351 Washington Blvd, Stamford, CT 06902 Phone: 203-621-3700
Ms. Sharon M Fornaciari, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 38 Hirsch Road, Stamford, CT 06905 Phone: 203-968-0451 Fax: 203-961-1223
Dr. James J. Wisecup, D.MIN. Counselor Medicare: Not Enrolled in Medicare Practice Location: 53 W Bank Ln, Stamford, CT 06902 Phone: 203-602-9969 Fax: 203-602-2234
William Earl Ezzelle, LPC Counselor Medicare: Medicare Enrolled Practice Location: 60 Palmers Hill Rd, Stamford, CT 06902 Phone: 203-614-9942
Ms. Susan K Cook, M.A., L.C.S.W., Counselor Medicare: Medicare Enrolled Practice Location: 48 Don Bob Rd, Stamford, CT 06903 Phone: 203-968-6180
Amanda Brown, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Buxton Farm Rd Ste 105, Stamford, CT 06905 Phone: 845-325-5511
Grace S Yang, Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Buxton Farm Rd Ste 105, Stamford, CT 06905 Phone: 203-674-8200

Mrs Madeline Mantilla, MS - Medicare Counselor in Stamford, CT