Tatiana Marie Mamantov, MD in Castro Valley, CA

Tatiana Marie Mamantov, MD is a medicare enrolled "Emergency Medicine" physician in Castro Valley, California. She went to East Tennessee State University Quillen College Of Medicine and graduated in 1984 and has 40 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Sharp Rees-stealy Medical Group Inc and her current practice location is 20103 Lake Chabot Rd, Castro Valley, California. You can reach out to her office (for appointments etc.) via phone at (209) 342-2300.

Tatiana Marie Mamantov is licensed to practice in California (license number G85179) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1629069059.

Contact Information

	Tatiana Marie Mamantov, MD
	20103 Lake Chabot Rd, Castro Valley, CA 94546-5341
	(209) 342-2300
	(209) 524-4240

Map and Direction

Physician's Profile

Full Name	Tatiana Marie Mamantov
Gender	Female
Speciality	Emergency Medicine
Experience	40 Years
Location	20103 Lake Chabot Rd, Castro Valley, California
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Tatiana Marie Mamantov attended and graduated from East Tennessee State University Quillen College Of Medicine in 1984

NPI Data:

NPI Number: 1629069059
Provider Enumeration Date: 11/03/2005
Last Update Date: 07/30/2008

Medicare PECOS Information:

PECOS PAC ID: 6608833975
Enrollment ID: I20041217000787

Medical Identifiers

Medical identifiers for Tatiana Marie Mamantov such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629069059	NPI	-	NPPES
00G851790	Other	CA	BLUE SHIELD
00G851790	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	G85179 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sharp Rees-stealy Medical Group Inc	8628972759	783

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. Tatiana Marie Mamantov allows following entities to bill medicare on her behalf.

Entity Name	University Of California Sfgh Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154396208 PECOS PAC ID: 5496668410 Enrollment ID: O20031113000632

Entity Name	Sharp Rees-stealy Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285616177 PECOS PAC ID: 8628972759 Enrollment ID: O20031120000996

Entity Name	Eden Emergency Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891786240 PECOS PAC ID: 7012802333 Enrollment ID: O20040217000163

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. Tatiana Marie Mamantov 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
Tatiana Marie Mamantov, MD 4301 Northstar Way, Modesto, CA 95356-9262 Ph: (209) 342-2300	Tatiana Marie Mamantov, MD 20103 Lake Chabot Rd, Castro Valley, CA 94546-5341 Ph: (209) 342-2300

Reviews and Comments

Emergency Medicine Doctors in Castro Valley, CA

Evan Taylor Wythe, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 209-342-2300 Fax: 209-524-4240
Thomas Eales, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-727-3320 Fax: 317-963-5394
Dr. Emily Rose Nelson, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 651-249-4082
Adria Simon, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-727-3015 Fax: 626-623-1227
Dr. Rahim James Sharifi, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20101 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-247-6300
Ralph James Damato, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 209-342-2300 Fax: 209-524-4240
Rochelle Ana Eggleston Philapil, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 209-342-2300 Fax: 209-524-4240

Tatiana Marie Mamantov, MD - Medicare Emergency Medicine in Castro Valley, CA