Dr Raul Alex Mancilla, OD is a medicare enrolled "Optometrist" provider in Imperial, California. His current practice location is
435 W Aten Rd Ste 3, Imperial, California. You can reach out to his office (for appointments etc.) via phone at
(760) 284-1442.
Dr Raul Alex Mancilla is licensed to practice in California (license number 12705TLG) 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 1487706198.
Healthcare Provider's Profile
| Full Name | Dr Raul Alex Mancilla |
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| Gender | Male |
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| Speciality | Optometrist |
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| Location | 435 W Aten Rd Ste 3, Imperial, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1487706198
- Provider Enumeration Date: 01/16/2007
- Last Update Date: 04/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 6608047857
- Enrollment ID: I20240430004275
Medical Identifiers
Medical identifiers for Dr Raul Alex Mancilla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487706198 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 12705TLG (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. Dr Raul Alex Mancilla allows following entities to bill medicare on his behalf.
| Provider Name | R Alex Mancilla Od Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1750169017
PECOS PAC ID: 4183064629
Enrollment ID: O20240430004194 |
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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. Dr Raul Alex 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 |
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Dr Raul Alex Mancilla, OD
1811 Farmer Dr,
El Centro, CA 92243
Ph: (619) 370-7315 | Dr Raul Alex Mancilla, OD
435 W Aten Rd Ste 3,
Imperial, CA 92251-9819
Ph: (760) 284-1442 |
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