Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Esteban Mantilla

Individual provider Physician Assistant · NPI 1235745605

Matthew Esteban Mantilla is a Physician Assistant in Cooperstown, New York. Qualified in 2020, 6 years ago. Practices with Novant Health Medical Group Coastal Region LLC, a 576-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
6
Licensed in
NC
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone: (607) 547-3456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1090 Medical Center Dr, Wilmington, NC 28401-7353 — (910) 662-8550

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-13280 (NC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1235745605
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 21, 2020
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Novant Health Medical Group Coastal Region Llc — 576 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Cooperstown