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MRS. MARA JASMIN BANUELOS FNP
NPI 1619721578
Nurse Practitioner - Family in Chino, CA

Active since April 16, 2024PECOS EnrolledAccepts Medicare Assignment
12296 ROSWELL AVE, CHINO, CA 91710(626) 348-7920 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Mara Jasmin Banuelos Fnp NPPES

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

MRS. MARA JASMIN BANUELOS FNP (NPI 1619721578) is an individual family provider in Chino, California, licensed in California (95029296) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1619721578
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. MARA JASMIN BANUELOSCredential: FNP
Location Address12296 ROSWELL AVEChino, CA 91710-2046
Mailing Address12296 Roswell AveChino, CA 91710-2046 · (626) 348-7920
Phone(626) 348-7920
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateApril 16, 2024
NPPES CertifiedApril 15, 2024
✔ NPI 1619721578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95029296
12296 ROSWELL AVE, Chino, CA 91710
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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

Mrs. Mara Jasmin Banuelos Fnp 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 ID8729514120
PECOS Enrollment IDI20241209003150
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

3

Medicare enrollment records show Mara Banuelos reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Swapna V Phadnis MD Inc
11 mi
Family Medicine
1315 S GRAND AVE STE 150
Glendora, CA 91740
  • Reassigned Medicare billing, California enrollment
  • 3 clinicians in this Medicare group
NPI 1609454297 (626) 914-0174
Jun R. Chiong, MD, Mph, Inc.
30 mi
Internal Medicine
461 TENNESSEE ST STE C
Redlands, CA 92373
  • Reassigned Medicare billing, California enrollment
  • 30 clinicians in this Medicare group
NPI 1093099046 (909) 475-7371
Supportive Care Specialists
38 mi
Clinic/Center
1171 S ROBERTSON BLVD STE 242
Los Angeles, CA 90035
  • Reassigned Medicare billing, California enrollment
  • 18 clinicians in this Medicare group
NPI 1518705771 (626) 765-4302

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 91710 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.

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 Mara Banuelos's NPI number?

The NPI number for Mara Banuelos is 1619721578. It was assigned to this individual provider in the NPPES registry on April 16, 2024.

Where is Mara Banuelos located?

Mara Banuelos practices at 12296 Roswell Ave, Chino, CA 91710. The listed phone number is (626) 348-7920.

What is Mara Banuelos's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mara Banuelos enrolled in Medicare?

Yes. Mara Banuelos 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 Mara Banuelos's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mara Banuelos reassigns Medicare benefits to 3 organizations: Swapna V Phadnis MD Inc (Glendora, CA), Jun R. Chiong, MD, Mph, Inc. (Redlands, CA) and Supportive Care Specialists (Los Angeles, 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 Mara Banuelos'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 Mara Banuelos was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.