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PREMALATA MANICKAM M.D.
NPI 1154353654
Pediatrics in Fontana, CA

Active since July 07, 2006PECOS Enrolled
9985 SIERRA AVE, KAISER PERMANENTE, MOB 2B, FONTANA, CA 92335(909) 427-5993(909) 427-4287 Get Directions Write a Review

NPPES record last updated: October 13, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Premalata Manickam M.d. NPPES

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

PREMALATA MANICKAM M.D. (NPI 1154353654) is an individual pediatrics provider in Fontana, California, licensed in California (C52156) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154353654
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NamePREMALATA MANICKAMCredential: M.D.
Location Address9985 SIERRA AVE, KAISER PERMANENTE, MOB 2BFontana, CA 92335-6720
Mailing Address9985 Sierra Ave, Kaiser Permanente ,pediatric Clinic Mob 2bFontana, CA 92335-6720 · (909) 427-5993 · Fax (909) 427-4287
Phone(909) 427-5993
Fax(909) 427-4287
Sole ProprietorYes
Enumeration DateJuly 7, 2006
Last NPPES UpdateOctober 13, 2021
NPPES CertifiedOctober 13, 2021
✔ NPI 1154353654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · C52156
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
9985 SIERRA AVE, Fontana, CA 92335
Open in Google Maps ↗

Other Identifiers 1

Medicaid3386785MI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premalata Manickam M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Premalata Manickam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
0.2 mi
Health Maintenance Organization
9961 SIERRA AVE
Fontana, CA 92335
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1952333460 (California)
  • 5,228 clinicians in this Medicare group
NPI 1689606196 (909) 427-3910

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 92335 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

NAINESH K. GANDHI MD
Internal Medicine (Cardiovascular Disease)
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (866) 454-3485
DR. PAYMON MESGARZADEH M.D.
Internal Medicine (Cardiovascular Disease)
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (909) 427-5000
DR. MARK JONATHAN LANDAU M.D., PH.D.
Plastic Surgery
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (833) 574-2273
DR. YUJIAN GUO M.D.
Psychiatry & Neurology (Neurology)
9985 SIERRA AVE, MOB-2, BASEMENT
FONTANA, CA 92335
San Bernardino County (909) 427-5000
MANUEL RICARDO MOJICA JR. M.D.
Internal Medicine
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (909) 427-5000
MR. FRED GADEA III
Physical Therapy Assistant
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (909) 427-5000
DR. ADEEL HUSAIN M.D.
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (909) 427-5000
PATRICIA LOTICH OTR
Occupational Therapist
9985 SIERRA AVE
FONTANA, CA 92335
San Bernardino County (909) 427-6996

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 Premalata Manickam's NPI number?

The NPI number for Premalata Manickam is 1154353654. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Premalata Manickam located?

Premalata Manickam practices at 9985 Sierra Ave Kaiser Permanente, Mob 2B, Fontana, CA 92335. The listed phone number is (909) 427-5993.

What is Premalata Manickam's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Premalata Manickam enrolled in Medicare?

Yes. Premalata Manickam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Premalata Manickam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Premalata Manickam reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The 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 Premalata Manickam'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 Premalata Manickam was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.