Jose Carlos Mancilla, NURSE PRACTITIONER in Concord, CA

Jose Carlos Mancilla, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner" in Concord, California. His current practice location is 2540 East St, Concord, California. You can reach out to his office (for appointments etc.) via phone at (925) 947-3322.

Jose Carlos Mancilla is licensed to practice in California (license number 95023101) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033836572.

Contact Information

	Jose Carlos Mancilla, NURSE PRACTITIONER
	2540 East St, Concord, CA 94520-1906
	(925) 947-3322
	(925) 947-3394

Map and Direction

Provider's Profile

Full Name	Jose Carlos Mancilla
Gender	Male
Speciality	Nurse Practitioner
Location	2540 East St, Concord, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033836572
Provider Enumeration Date: 10/25/2022
Last Update Date: 05/28/2023

Medicare PECOS Information:

PECOS PAC ID: 2062933757
Enrollment ID: I20250311001336

Medical Identifiers

Medical identifiers for Jose Carlos Mancilla such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033836572	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	95023101 (California)	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. Jose Carlos Mancilla allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Jose Carlos Mancilla 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
Jose Carlos Mancilla, NURSE PRACTITIONER 2540 East St, Concord, CA 94520-1906 Ph: (925) 947-3322	Jose Carlos Mancilla, NURSE PRACTITIONER 2540 East St, Concord, CA 94520-1906 Ph: (925) 947-3322

Reviews and Comments

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Jose Carlos Mancilla, NURSE PRACTITIONER - Medicare Nurse Practitioner in Concord, CA