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JOSE CARLOS MANCILLA NURSE PRACTITIONER
NPI 1033836572
Nurse Practitioner in Concord, CA

Active since October 25, 2022PECOS EnrolledAccepts Medicare Assignment
2540 EAST ST, CONCORD, CA 94520(925) 947-3322(925) 947-3394 Get Directions Write a Review

NPPES record last updated: May 28, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 28, 2023, Oct 25, 2022 (2 updates tracked since 2022).

About Jose Carlos Mancilla Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSE CARLOS MANCILLA NURSE PRACTITIONER (NPI 1033836572) is an individual nurse practitioner in Concord, California, licensed in California (95023101) and active in the NPI registry since October 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1033836572
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameJOSE CARLOS MANCILLACredential: NURSE PRACTITIONER
Location Address2540 EAST STConcord, CA 94520-1906
Mailing Address2540 East StConcord, CA 94520-1906 · (925) 947-3322 · Fax (925) 947-3394
Phone(925) 947-3322
Fax(925) 947-3394
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 25, 2022
Last NPPES UpdateMay 28, 20232 updates tracked since enumeration
NPPES CertifiedMay 28, 2023
✔ NPI 1033836572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95023101
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
2540 EAST ST, Concord, CA 94520
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jose Carlos Mancilla Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062933757
PECOS Enrollment IDI20250311001336
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jose Mancilla reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc
17 mi
Internal Medicine
975 SERENO DRIVE
Vallejo, CA 94589
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1336222397 (707) 651-1000
Northbay Health Medical Foundation
19 mi
Internal Medicine
4500 BUSINESS CENTER DR
Fairfield, CA 94534
  • Reassigned Medicare billing, California enrollment
  • 225 clinicians in this Medicare group
NPI 1760283527 (707) 646-3110

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94520 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. COLLEEN MARIE STAGG PHARMD
Pharmacist
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (925) 674-2130
DR. CHRISTINE E CESCA MD
Pathology (Anatomic Pathology & Clinical Pathology)
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (925) 674-2506
BAY AREA THERAPEUTIC RADIOLOGY & ONCOLOGY ASSOC MED GRP INC
Radiology (Radiation Oncology)
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (209) 342-2300
MARJANEH MOINI MD
Radiology (Radiation Oncology)
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (209) 342-2300
NOREEN DEL NAPOLES
Nurse Practitioner (Family)
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (925) 392-8849
CATHERINE M HURT M.D.
Emergency Medicine
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (925) 682-8200
NADER SHIHABI MD
Pathology (Anatomic Pathology & Clinical Pathology)
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (925) 674-2506
DR. JERRY MICHAEL HORNER PHARM.D,
Pharmacist
2540 EAST ST
CONCORD, CA 94520
Contra Costa County (925) 682-8200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jose Mancilla's NPI number?

The NPI number for Jose Mancilla is 1033836572. It was assigned to this individual provider in the NPPES registry on October 25, 2022.

Where is Jose Mancilla located?

Jose Mancilla practices at 2540 East St, Concord, CA 94520. The listed phone number is (925) 947-3322.

What is Jose Mancilla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jose Mancilla enrolled in Medicare?

Yes. Jose Mancilla is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jose Mancilla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jose Mancilla reassigns Medicare benefits to 2 organizations: Permanente Medical Group Inc (Vallejo, CA) and Northbay Health Medical Foundation (Fairfield, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jose Mancilla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jose Mancilla was last updated on May 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.