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KATHLENE MANIMTIM NGUYEN
NPI 1699415620
Nurse Practitioner in Fontana, CA

Active since March 29, 2022PECOS Enrolled
7159 MYRTLE PL, FONTANA, CA 92336(619) 415-9181 Get Directions Write a Review

NPPES record last updated: March 29, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kathlene Manimtim Nguyen NPPES

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

KATHLENE MANIMTIM NGUYEN (NPI 1699415620) is an individual nurse practitioner in Fontana, California, licensed in California (95020377) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1699415620
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKATHLENE MANIMTIM NGUYEN
Location Address7159 MYRTLE PLFontana, CA 92336-5706
Mailing Address7159 Myrtle PlFontana, CA 92336-5706 · (619) 415-9181
Phone(619) 415-9181
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 29, 2022
NPPES CertifiedMarch 29, 2022
✔ NPI 1699415620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95020377
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
7159 MYRTLE PL, Fontana, CA 92336
Open in Google Maps ↗

Other Names 1

Former Name (1)Kathlene Villegas Manimtim

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathlene Manimtim Nguyen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224406681
PECOS Enrollment IDI20251208001666
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

2

Medicare enrollment records show Kathlene Nguyen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pair Team Medical Group Of California PC
374 mi
Family Medicine
95 3RD ST STE 293
San Francisco, CA 94103
  • Reassigned Medicare billing, California enrollment
  • 28 clinicians in this Medicare group
NPI 1134838352 (707) 207-6571
Pair Team Medical Group, P.A.
374 mi
Family Medicine
95 3RD ST STE 293
San Francisco, CA 94103
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Pair Team Medical Group PA
  • 28 clinicians in this Medicare group
NPI 1659132553 (707) 207-6571

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 92336 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 Kathlene Nguyen's NPI number?

The NPI number for Kathlene Nguyen is 1699415620. It was assigned to this individual provider in the NPPES registry on March 29, 2022. The provider is also known as Kathlene Villegas Manimtim.

Where is Kathlene Nguyen located?

Kathlene Nguyen practices at 7159 Myrtle Pl, Fontana, CA 92336. The listed phone number is (619) 415-9181.

What is Kathlene Nguyen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kathlene Nguyen enrolled in Medicare?

Yes. Kathlene Nguyen is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kathlene Nguyen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathlene Nguyen reassigns Medicare benefits to 2 organizations: Pair Team Medical Group Of California PC (San Francisco, CA) and Pair Team Medical Group, P.A. (San Francisco, 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 Kathlene Nguyen'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 Kathlene Nguyen was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.