DR. TREVI ANN MANCILLA MD, PHD
NPI 1760069066
Student in an Organized Health Care Education/Training Program in Idaho Falls, ID

Q: What is Trevi Mancilla's NPI number?

The NPI number for Trevi Mancilla is 1760069066. It was assigned to this individual provider in the NPPES registry on March 24, 2021. The provider is also known as Trevi Ann Mancilla.

Q: What is Trevi Mancilla's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Trevi Mancilla was last updated on March 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since March 24, 2021PECOS Enrolled

3100 CHANNING WAY, IDAHO FALLS, ID 83404(208) 529-6111 Get Directions Write a Review

NPPES record last updated: March 30, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 30, 2021, Mar 24, 2021 (2 updates tracked since 2021).

On this page

About Dr. Trevi Ann Mancilla Md, Phd NPPES

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

DR. TREVI ANN MANCILLA MD, PHD (NPI 1760069066) is an individual student in an organized health care education/training program in Idaho Falls, Idaho and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760069066

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. TREVI ANN MANCILLACredential: MD, PHD

Location Address3100 CHANNING WAYIdaho Falls, ID 83404-7533

Mailing Address3100 Channing WayIdaho Falls, ID 83404-7533 · (208) 529-6111

Phone(208) 529-6111

Sole ProprietorNo

Enumeration DateMarch 24, 2021

Last NPPES UpdateMarch 30, 20212 updates tracked since enumeration

NPPES CertifiedMarch 30, 2021

✔ NPI 1760069066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3100 CHANNING WAY, Idaho Falls, ID 83404

Open in Google Maps ↗

Other Names 1

Former Name (1)Trevi Ann Mancilla

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Trevi Ann Mancilla Md, Phd 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.

Other Providers at the Same Location NPPES 20

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

CARL SAMUEL BRAYTON DO

Student in an Organized Health Care Education/Training Program