Guillermo Alberto Mantilla, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

C159709 Issued in CA

Practice address

6555 Coyle Ave Ste 280
Carmichael, CA 95608-0302

Phone

(916) 536-3540

Fax

(916) 536-3541

NPI assigned

Sep 19, 2007

Last updated

Feb 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Hospitalist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516
• Mercy General Hospital Hospital, Sacramento, CA, CCN 050017

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dignity Health Medical Foundation

  dba Mercy Medical Group, a service of Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - North State, a service of Dignity Healt

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Summit Medical Group, PLLC

  dba Summit Express Clinic at Fountain City

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1225117583
  NPD
• Dignity Health

  dba Mercy Hospital of Folsom

  • General Acute Care Hospital
  • Folsom, CA
  • NPI 1356389878
  NPD (past)
• Dignity Health

  dba Mercy General Hospital

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  NPD (past)
• Dignity Health

  dba Mercy San Juan Medical Center

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  NPD (past)
• Cookeville Regional Medical Group, Inc

  • Multi-Specialty Clinic/Center
  • Cookeville, TN
  • NPI 1649202102
  NPD (past)
• Cumberland Medical Center, Inc

  dba CMC Physician Group

  • Internal Medicine Physician
  • Crossville, TN
  • NPI 1053377812
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  dba Mercy General Hospital

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  Care Compare affiliation
• Dignity Health

  dba Mercy San Juan Medical Center

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  Care Compare affiliation

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1326234816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 COYLE AVE STE 280",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080302",
            "telephone_number": "916-536-3540",
            "fax_number": "916-536-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTILLA",
        "first_name": "GUILLERMO",
        "middle_name": "ALBERTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "42647",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C159709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100423880",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4352401",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1512334",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Binita Mandal, MD
• Rachel Kathryn Maney, MD
• Hasandeep S Mann, MD
• Jordan Mann
• Manpreet K Gill MD PC (Placer Family Medicine)
• Araxia Manukyan
• Maria Leigh Manyaga
• Anna Manzyuk, NP
• Donna Lorraine Marasigan
• Michele March

• Hospitalist Physician in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.