Soleima Dallana Mantilla, NP in Mansfield, TX

Soleima Dallana Mantilla, NP is a medicare enrolled "Nurse Practitioner - Gerontology" in Mansfield, Texas. Her current practice location is 1900 Matlock Rd Ste 804, Mansfield, Texas. You can reach out to her office (for appointments etc.) via phone at (682) 800-3211.

Soleima Dallana Mantilla is licensed to practice in Texas (license number 1093926) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669183463.

Contact Information

	Soleima Dallana Mantilla, NP
	1900 Matlock Rd Ste 804, Mansfield, TX 76063-4455
	(682) 800-3211
	Not Available

Map and Direction

Provider's Profile

Full Name	Soleima Dallana Mantilla
Gender	Female
Speciality	Nurse Practitioner - Gerontology
Location	1900 Matlock Rd Ste 804, Mansfield, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669183463
Provider Enumeration Date: 12/12/2022
Last Update Date: 07/05/2023

Medicare PECOS Information:

PECOS PAC ID: 9537516307
Enrollment ID: I20231116000163

Medical Identifiers

Medical identifiers for Soleima Dallana Mantilla such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669183463	NPI	-	NPPES
45220	Other	TX	TEXAS BOARD OF NURSING

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	1093926 (Texas)	Secondary
363LG0600X	Nurse Practitioner - Gerontology	1093926 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Soleima Dallana Mantilla allows following entities to bill medicare on her behalf.

Entity Name	Texas Health Care Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477628873 PECOS PAC ID: 7214840867 Enrollment ID: O20031110000388

Entity Name	Texas Oncology Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811944101 PECOS PAC ID: 5395658934 Enrollment ID: O20031124000323

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Soleima Dallana Mantilla is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Soleima Dallana Mantilla, NP 1900 Matlock Rd Ste 804, Mansfield, TX 76063-4455 Ph: (682) 800-3211	Soleima Dallana Mantilla, NP 1900 Matlock Rd Ste 804, Mansfield, TX 76063-4455 Ph: (682) 800-3211

Reviews and Comments

Nurse Practitioner Nurses in Mansfield, TX

Ms. Courtney Miller, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1707 Clover Hill Rd, Mansfield, TX 76063 Phone: 817-456-8798
Mr. Laurence A. Gadbois Jr., FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2303 Lockshire Dr, Mansfield, TX 76063 Phone: 682-225-0319
Mrs. Linda Gail Langston, RNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2800 E Broad Street Suite 400, Mansfield, TX 76063 Phone: 817-477-9292
Mrs. Renee Rachelle Baril, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 120 N Miller Rd Ste 300, Mansfield, TX 76063 Phone: 682-341-7510 Fax: 682-341-7511
Mrs. Saaghe Mmbi Fogwe, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1475 Heritage Pkwy Ste 225, Mansfield, TX 76063 Phone: 817-453-7522 Fax: 866-665-6659
Oluwatosin B Ajibola, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 300 Captains Ct, Mansfield, TX 76063 Phone: 817-239-2205
Mrs. Tanita Breyannen Denae Butler, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2200 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-0267

Soleima Dallana Mantilla, NP - Medicare Nurse Practitioner in Mansfield, TX