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DOMINADOR PERALTA MANSAT JR. FNP-C
NPI 1700500600
Nurse Practitioner - Family in Ontario, CA

Active since October 04, 2022PECOS EnrolledAccepts Medicare Assignment
7.27/100
CMS Quality Rating
1910 S ARCHIBALD AVE STE D, ONTARIO, CA 91761(909) 348-2556(877) 615-1555 Get Directions Write a Review

NPPES record last updated: October 4, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dominador Peralta Mansat Jr. Fnp-c NPPES

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

DOMINADOR PERALTA MANSAT JR. FNP-C (NPI 1700500600) is an individual family provider in Ontario, California, licensed in California (95022872) and active in the NPI registry since October 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1700500600
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDOMINADOR PERALTA MANSAT JR.Credential: FNP-C
Location Address1910 S ARCHIBALD AVE STE DOntario, CA 91761-8503
Mailing Address9415 Retreat PlRancho Cucamonga, CA 91730-9200 · (909) 348-3067 · Fax (877) 615-1555
Phone(909) 348-2556
Fax(877) 615-1555
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 4, 2022
NPPES CertifiedOctober 4, 2022
✔ NPI 1700500600 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 · 95022872
1910 S ARCHIBALD AVE STE D, Ontario, CA 91761
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dominador Peralta Mansat Jr. Fnp-c 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 ID8426424524
PECOS Enrollment IDI20221024001380
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
3,261 services195 patients
Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344
A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91761 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

7.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost24.24

Other Providers at the Same Location NPPES 2

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

MYOTHERAPY BODYWORK AND REHABILITATION
Massage Therapist
1910 S ARCHIBALD AVE STE D
ONTARIO, CA 91761
San Bernardino County (909) 569-3913
DOMINADOR MANSAT JR, A PROFESSIONAL NURSING CORP
Nurse Practitioner (Family)
1910 S ARCHIBALD AVE STE D
ONTARIO, CA 91761
San Bernardino County (909) 348-2556

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 Dominador Mansat's NPI number?

The NPI number for Dominador Mansat is 1700500600. It was assigned to this individual provider in the NPPES registry on October 4, 2022.

Where is Dominador Mansat located?

Dominador Mansat practices at 1910 S Archibald Ave Ste D, Ontario, CA 91761. The listed phone number is (909) 348-2556.

What is Dominador Mansat's specialty?

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

Is Dominador Mansat enrolled in Medicare?

Yes. Dominador Mansat 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.

When was this NPI record last updated?

The NPPES record for Dominador Mansat was last updated on October 4, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.