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NATASHA VICTORIA RODRIGUEZ MANCEBO PA-C
NPI 1588201115
Physician Assistant in Peoria, IL

Active since December 02, 2019PECOS Enrolled
711 W JOHN GWYNN AVE, PEORIA, IL 61605(309) 680-7600(309) 671-2188 Get Directions Write a Review

NPPES record last updated: December 2, 2019. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Natasha Victoria Rodriguez Mancebo Pa-c NPPES

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

NATASHA VICTORIA RODRIGUEZ MANCEBO PA-C (NPI 1588201115) is an individual physician assistant in Peoria, Illinois, licensed in Illinois (085007443) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588201115
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameNATASHA VICTORIA RODRIGUEZ MANCEBOCredential: PA-C
Location Address711 W JOHN GWYNN AVEPeoria, IL 61605-2270
Mailing Address2214 N University StPeoria, IL 61604-3221 · (309) 680-7669 · Fax (309) 681-8443
Phone(309) 680-7600
Fax(309) 671-2188
Sole ProprietorNo
Enumeration DateDecember 2, 2019
✔ NPI 1588201115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085007443
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.
711 W JOHN GWYNN AVE, Peoria, IL 61605
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Natasha Victoria Rodriguez Mancebo 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 61605 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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 3

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

DAVID GLENN SPRINGER M.D.
Family Medicine
711 W JOHN GWYNN AVE
PEORIA, IL 61605
Peoria County (309) 680-7600
CRISTY LEE TOMASZEWSKI LCSW
Social Worker (Clinical)
711 W JOHN GWYNN AVE
PEORIA, IL 61605
Peoria County (309) 680-7600
PUNAM SUBHASHCHANDRA TRIVEDE APN
Nurse Practitioner (Family)
711 W JOHN GWYNN AVE
PEORIA, IL 61605
Peoria County (309) 680-7600

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 Natasha Rodriguez Mancebo's NPI number?

The NPI number for Natasha Rodriguez Mancebo is 1588201115. It was assigned to this individual provider in the NPPES registry on December 2, 2019.

Where is Natasha Rodriguez Mancebo located?

Natasha Rodriguez Mancebo practices at 711 W John Gwynn Ave, Peoria, IL 61605. The listed phone number is (309) 680-7600.

What is Natasha Rodriguez Mancebo's specialty?

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

Is Natasha Rodriguez Mancebo enrolled in Medicare?

Yes. Natasha Rodriguez Mancebo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Natasha Rodriguez Mancebo was last updated on December 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.