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DR. AXLE MARIA RAFAELLE DIMAYUGA UNTALAN MD
NPI 1871225847
Internal Medicine in Paradise, CA

Active since June 28, 2022PECOS Enrolled
5125 SKYWAY, PARADISE, CA 95969(530) 872-2000(530) 332-1049 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Axle Maria Rafaelle Dimayuga Untalan Md NPPES

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

DR. AXLE MARIA RAFAELLE DIMAYUGA UNTALAN MD (NPI 1871225847) is an individual internal medicine provider in Paradise, California, licensed in California (A200859) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871225847
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. AXLE MARIA RAFAELLE DIMAYUGA UNTALANCredential: MD
Location Address5125 SKYWAYParadise, CA 95969-5624
Mailing Address5125 SkywayParadise, CA 95969-5624 · (530) 872-2000 · Fax (530) 332-1049
Phone(530) 872-2000
Fax(530) 332-1049
Sole ProprietorNo
Enumeration DateJune 28, 2022
Last NPPES UpdateJune 27, 2025
NPPES CertifiedJune 27, 2025
✔ NPI 1871225847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A200859
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5125 SKYWAY, Paradise, CA 95969
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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 (PECOS)

Dr. Axle Maria Rafaelle Dimayuga Untalan Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Axle Maria Rafaelle Untalan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Adventist Health Clearlake Hospital Inc.
77 mi
Critical Access
15630 18TH AVE
Clearlake, CA 95422
  • Reassigned Medicare billing, California enrollment
  • 182 clinicians in this Medicare group
NPI 1124018031 (707) 994-6486

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 95969 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

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.

DOUGLAS L. EDGAR P.A.
Physician Assistant
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 872-2000
LORI M MASON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 876-2000
CHARLES E DENMAN M.D.
Internal Medicine
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 872-2000
ADVENTIST HEALTH PHYSICIANS NETWORK
Family Medicine
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 872-2000
MALGORZATA MORDARSKA
Physician Assistant
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 872-2000
MR. JOSEPH R ACCIAIOLI LCSW
Social Worker (Clinical)
5125 SKYWAY
PARADISE, CA 95969
Butte County (503) 238-0705
MS. SUKHDEEP KAUR MD
Hospitalist
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 872-2000
JADIE JOAN SWIETANSKI FNP-BC
Nurse Practitioner (Family)
5125 SKYWAY
PARADISE, CA 95969
Butte County (530) 872-2000

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 Axle Maria Rafaelle Untalan's NPI number?

The NPI number for Axle Maria Rafaelle Untalan is 1871225847. It was assigned to this individual provider in the NPPES registry on June 28, 2022.

Where is Axle Maria Rafaelle Untalan located?

Axle Maria Rafaelle Untalan practices at 5125 Skyway, Paradise, CA 95969. The listed phone number is (530) 872-2000.

What is Axle Maria Rafaelle Untalan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Axle Maria Rafaelle Untalan enrolled in Medicare?

Yes. Axle Maria Rafaelle Untalan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Axle Maria Rafaelle Untalan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Axle Maria Rafaelle Untalan reassigns Medicare benefits to Adventist Health Clearlake Hospital Inc. (Clearlake, CA). The 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 Axle Maria Rafaelle Untalan'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 Axle Maria Rafaelle Untalan was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.