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NPI Code Detail

MEDICARE: NICHOLAS MANTEI PA-C

MEDICARE: NICHOLAS MANTEI PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1851155295
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS MANTEI PA-C
Provider Business Mailing Address
First Line : 2988 PRESTON ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57703-5510
Country : US
Telephone Number : 719-568-4946
Fax Number :
Provider Business Practice Location Address
First Line : 7220 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-8754
Country : US
Telephone Number : 605-646-9588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2024
Last Update Date : 02/02/2026

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Directions to “ NICHOLAS MANTEI PA-C” Practice Location

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