Soleima Dallana Mantilla, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

1093926 Issued in TX

Practice address

1900 Matlock Rd Ste 804
Mansfield, TX 76063-4455

Phone

(682) 800-3211

NPI assigned

Dec 12, 2022

Last updated

Jul 5, 2023By the provider in NPPES

Sex

Female

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 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Merit-based Incentive Payment System (MIPS)

Final score

85.12 of 100Reported as apm

Quality

67.48

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: soleima.mantilla@txo.ikm.direct-ci.com

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.

• Texas Oncology PA

  • Medical Oncology Physician
  • El Paso, TX
  • NPI 1811944101
  Medicare reassignment Care Compare group NPD
• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352
  NPD
• Texas Health Care, P.L.L.C.

  • Obstetrics & Gynecology Physician
  • Haltom City, TX
  • NPI 1821145764
  NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Pearland, TX
  • NPI 1912174350
  NPD

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

• Bir JV LLP

  dba Baylor Institute for Rehabilitation

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1669183463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MATLOCK RD STE 804",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634455",
            "telephone_number": "682-800-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MATLOCK RD STE 804",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634455",
            "telephone_number": "682-800-3211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8110 Park Ln Apt 227",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752316088",
            "country_code": "US",
            "telephone_number": "214-763-9446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTILLA",
        "first_name": "SOLEIMA",
        "middle_name": "DALLANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1093926",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1093926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "45220",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mansfield SNF LLC (Isle at Watercrest - Mansfield, LLC)
• Mansfield Spinal Care
• Mansfield Surgical Plaza LLC (Mansfield Surgery Center)
• Mansfield Vision Center LLC
• Mansfield Walnut Creek Medical (First Choice Emergency Room)
• Miranda Manyande, M. S. CCC-SLP
• Tokriel M Manyiel
• Arash Manzori, DO
• Donald Chris Mappes, PH.D.
• Marcia T Sampson MD PA (Mansfield Pediatrics)

• Gerontology Nurse Practitioner in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.