=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134562614
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BENJAMIN S MANTELL MD, PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2013
-----------------------------------------------------
Last Update Date | 10/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3333 BURNET AVE THE HEART INSTITUTE, CINCINNATI CHILDREN'S HOSPITAL MED
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45229-3026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-803-1675
-----------------------------------------------------
Fax | 513-636-3952
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3333 BURNET AVE, CINCINNATI CHILDREN'S HOSPITAL MED CTR THE HEART INSTITUTE, MLC 2003
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45229-3026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-803-1675
-----------------------------------------------------
Fax | 513-636-3952
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 35.147922
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2080P0202X
-----------------------------------------------------
Taxonomy Name | Pediatric Cardiology Physician
-----------------------------------------------------
License Number | 35.147922
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------