DR. ELIAS MORENO MANDUJANO DO
NPI 1477283679
Family Medicine in Tallahassee, FL

Q: What is Elias Moreno Mandujano's NPI number?

The NPI number for Elias Moreno Mandujano is 1477283679. It was assigned to this individual provider in the NPPES registry on June 13, 2022. The provider is also known as Elias Moreno.

Q: What is Elias Moreno Mandujano's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since June 13, 2022PECOS Enrolled

2140 CENTERVILLE RD, TALLAHASSEE, FL 32308(850) 383-3339 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Elias Moreno Mandujano Do NPPES

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

DR. ELIAS MORENO MANDUJANO DO (NPI 1477283679) is an individual family medicine provider in Tallahassee, Florida, licensed in Florida (OS20619) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2022).

NPPES Registry Identity

NPI1477283679

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. ELIAS MORENO MANDUJANOCredential: DO

Location Address2140 CENTERVILLE RDTallahassee, FL 32308-4314

Mailing Address1301 Hodges DrTallahassee, FL 32308-4614

Phone(850) 383-3339

Sole ProprietorYes

Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2022

Enumeration DateJune 13, 2022

Last NPPES UpdateJuly 28, 2025

NPPES CertifiedJuly 28, 2025

✔ NPI 1477283679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · OS20619

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2140 CENTERVILLE RD, Tallahassee, FL 32308

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Other Names 1

Other Name (5)Elias Moreno

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Capital Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Elias Moreno Mandujano Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2961883673

PECOS Enrollment IDI20240802001784

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 Elias Moreno Mandujano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Capital Health Plan, Inc,

0.1 mi

Health Maintenance Organization

2140 CENTERVILLE PL
Tallahassee, FL 32308

Reassigned Medicare billing, Florida enrollment
71 clinicians in this Medicare group

NPI 1770688566 (850) 383-3333

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 32308 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 16

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

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