Individual provider Active NPI

Ramiro Mancilla Jr., MD

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1316787393
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
786635 Issued in TX
Practice address
1501 Red River St
Austin, TX 78712-1845
Phone
(512) 495-5555
NPI assigned
May 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 786635 TX Primary

Addresses

Primary practice location

1501 Red River St
Austin, TX 78712-1845

Mailing address

1501 Red River St
Austin, TX 78712-1845
Phone (512) 495-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240618003384 TX Order and Referring Only - Family PracticePractitioner - Family Practice 3072056043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
786635TXMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: rmancilla1004714@ahs.direct-ci.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1316787393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845",
            "telephone_number": "512-495-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845",
            "telephone_number": "512-495-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCILLA",
        "first_name": "RAMIRO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "786635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.