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CAROLINA MARIE MANCEAUX PA-C
NPI 1124736319
Physician Assistant in Valdosta, GA

Active since November 07, 2022PECOS Enrolled
2409 N PATTERSON ST, VALDOSTA, GA 31602(229) 259-4369 Get Directions Write a Review

NPPES record last updated: May 14, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 14, 2026, Mar 8, 2023, Nov 7, 2022 (3 updates tracked since 2022).

About Carolina Marie Manceaux Pa-c NPPES

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

CAROLINA MARIE MANCEAUX PA-C (NPI 1124736319) is an individual physician assistant in Valdosta, Georgia, licensed in Utah (14267404-1206) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Sandy.

NPPES Registry Identity

NPI1124736319
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCAROLINA MARIE MANCEAUXCredential: PA-C
Location Address2409 N PATTERSON STValdosta, GA 31602-2512
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128
Phone(229) 259-4369
Sole ProprietorNo
Enumeration DateNovember 7, 2022
Last NPPES UpdateMay 14, 20263 updates tracked since enumeration
NPPES CertifiedMay 14, 2026
✔ NPI 1124736319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in UT · 14267404-1206✔ Licensed in GA · 11461
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2409 N PATTERSON ST, Valdosta, GA 31602
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Other Names 1

Former Name (1)Carolina Reis

Secondary Practice Location 1

Location 19450 S 1300 ESandy, UT 84094-5555 · Phone (801) 501-2160

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolina Marie Manceaux Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31602 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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 2

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

JANA HARROD APRN
Nurse Practitioner (Adult Health)
2409 N PATTERSON ST, SUITE 230
VALDOSTA, GA 31602
Lowndes County (229) 259-4369
MR. DARYOOSH DERAKHSHAN D.O.
Internal Medicine (Interventional Cardiology)
2409 N PATTERSON ST
VALDOSTA, GA 31602
Lowndes County (229) 433-8160

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 Carolina Manceaux's NPI number?

The NPI number for Carolina Manceaux is 1124736319. It was assigned to this individual provider in the NPPES registry on November 7, 2022. The provider is also known as Carolina Reis.

Where is Carolina Manceaux located?

Carolina Manceaux practices at 2409 N Patterson St, Valdosta, GA 31602. The listed phone number is (229) 259-4369.

What is Carolina Manceaux's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Carolina Manceaux enrolled in Medicare?

Yes. Carolina Manceaux is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carolina Manceaux was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.